Lee Stoner1, Michelle L Meyer2, Anna Kucharska-Newton3,4, Keeron Stone5, Gabriel Zieff1, Gaurav Dave6, Simon Fryer5, Daniel Credeur7, James Faulkner8, Kunihiro Matsushita9, Timothy M Hughes10, Hirofumi Tanaka11. 1. Department of Exercise and Sport Science. 2. Department of Emergency Medicine, School of Medicine. 3. Department of Epidemiology, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 4. Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, Kentucky, USA. 5. School of Sport and Exercise, University of Gloucestershire, Gloucester, UK. 6. Division of General Internal Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 7. School of Kinesiology, University of Southern Mississippi, Hattiesburg, Mississippi, USA. 8. Department of Sport & Exercise, University of Winchester, Winchester, UK. 9. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 10. Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina. 11. Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA.
Abstract
BACKGROUND: Carotid-femoral pulse wave velocity (cfPWV) is widely used in epidemiological studies to assess central arterial stiffness. However, despite being superior to traditional risk factors in predicting cardiovascular outcomes, cfPWV is not routinely used in clinical practice. cfPWV assessments require applanation of the carotid artery, which can be cumbersome, and individual-level factors, including carotid artery plaque, may confound the measurements. Heart-femoral PWV (hfPWV) may be a suitable alternative measure of central arterial stiffness. OBJECTIVES: The aim of this study was to estimate the strength of the agreement between hfPWV and cfPWV. METHODS: We evaluated 4133 older-aged [75.2 (5.0) years] African-American and white adults in the community-based Atherosclerosis Risk in Communities (ARIC) Study. cfPWV and hfPWV were measured using an automated cardiovascular screening device. Agreement between the two measurements was determined using Pearson's correlation coefficient (r), standard error of estimate (SEE) and Bland-Altman analysis. RESULTS: There was a strong (r > 0.7) agreement between hfPWV and cfPWV (r = 0.83, 95% CI: 0.82-0.84). Although the mean cfPWV [11.5 m/s (SD: 3.0)] and hfPWV [11.5 m/s (SD: 2.3)] were comparable, the SEE was 1.7 m/s. Inspection of the Bland-Altman plot revealed greater variability and bias for higher PWV values, with higher PWV further away from the regression line. DISCUSSION: Findings suggest good agreement between hfPWV and cfPWV. hfPWV is a simpler alternative to cfPWV that is less likely to be confounded by individual-level factors. Considering the greater variability for higher PWV values, further work is warranted to determine the importance of local artery mechanics to both measures.
BACKGROUND: Carotid-femoral pulse wave velocity (cfPWV) is widely used in epidemiological studies to assess central arterial stiffness. However, despite being superior to traditional risk factors in predicting cardiovascular outcomes, cfPWV is not routinely used in clinical practice. cfPWV assessments require applanation of the carotid artery, which can be cumbersome, and individual-level factors, including carotid artery plaque, may confound the measurements. Heart-femoral PWV (hfPWV) may be a suitable alternative measure of central arterial stiffness. OBJECTIVES: The aim of this study was to estimate the strength of the agreement between hfPWV and cfPWV. METHODS: We evaluated 4133 older-aged [75.2 (5.0) years] African-American and white adults in the community-based Atherosclerosis Risk in Communities (ARIC) Study. cfPWV and hfPWV were measured using an automated cardiovascular screening device. Agreement between the two measurements was determined using Pearson's correlation coefficient (r), standard error of estimate (SEE) and Bland-Altman analysis. RESULTS: There was a strong (r > 0.7) agreement between hfPWV and cfPWV (r = 0.83, 95% CI: 0.82-0.84). Although the mean cfPWV [11.5 m/s (SD: 3.0)] and hfPWV [11.5 m/s (SD: 2.3)] were comparable, the SEE was 1.7 m/s. Inspection of the Bland-Altman plot revealed greater variability and bias for higher PWV values, with higher PWV further away from the regression line. DISCUSSION: Findings suggest good agreement between hfPWV and cfPWV. hfPWV is a simpler alternative to cfPWV that is less likely to be confounded by individual-level factors. Considering the greater variability for higher PWV values, further work is warranted to determine the importance of local artery mechanics to both measures.
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