Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging

Summary

Pulse wave velocity (PWV) measurement assesses arterial stiffness by a tonometry-based system that measures the speed with which arterial pressure wave travels along the arterial tree, typically approximating the time that it takes this wave to travel from the descending aorta (using the carotid artery as a surrogate) to the femoral artery. Carotid-femoral PWV increases two- to threefold across the adult lifespan.

Abstract

Carotid-femoral pulse wave velocity is considered the gold standard for measurements of central arterial stiffness obtained through noninvasive methods¹. Subjects are placed in the supine position and allowed to rest quietly for at least 10 min prior to the start of the exam. The proper cuff size is selected and a blood pressure is obtained using an oscillometric device. Once a resting blood pressure has been obtained, pressure waveforms are acquired from the right femoral and right common carotid arteries. The system then automatically calculates the pulse transit time between these two sites (using the carotid artery as a surrogate for the descending aorta). Body surface measurements are used to determine the distance traveled by the pulse wave between the two sampling sites. This distance is then divided by the pulse transit time resulting in the pulse wave velocity. The measurements are performed in triplicate and the average is used for analysis.

Introduction

Pulse Wave Velocity (PWV) is regarded as the gold standard in the assessment of arterial stiffness². While not used clinically in the United States, it has been validated and widely used in clinical settings throughout Europe³. Changes in PWV have been correlated with cardiovascular risk factors such as hypertension, obesity, impaired glucose tolerance, and dyslipidemia. Higher aortic stiffness has been associated with increased risk for a first cardiovascular event⁴, muscle mass decline⁵, and slower gait speed in subjects with peripheral arterial disease⁶. Assessment of PWV is accomplished by analyzing the speed ....

Protocol

1. Procedure

1. Open the software via the shortcut on your Windows desktop by double-clicking on the icon.
2. Click Patient to activate the Patient Screen.
3. To enter a new patient into the database, click the New button in the patient search area, and then click on the Yes button to confirm you would like to enter a new patient.
4. Enter patient details such as last name, first name, date of birth, and gender. Click on the Save button to advance to the next step.
5. Click the PWA or PWV button to perform measurement. If only one of these modes is available, there is no need to click on the button, simply proceed to the study scre....

Results

Table 1. PWV results are produced in meters per second. In healthy subjects, these speeds can range from an average 6.2 m/sec (in subjects under 30) to 10.9 m/sec (in subjects .......

Discussion

The measurement of pulse wave velocity (PWV) is a noninvasive method for analyzing central arterial stiffness in a relatively simple and reproducible manner³. To assess PWV, the carotid (as a surrogate for the descending aorta) and femoral pulse waveforms are acquired using a high-fidelity tonometer; the time delay in pulse wave arrival at the between the two sites is estimated referencing to a concurrently recorded EKG waves by custom designed computer software that conforms to the propagative model of the ar.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
SphygmoCor System	AtCor	SPT-304, Module EM3