Utility of estimated pulse wave velocity for assessing vascular stiffness: comparison of methods
- German Aerospace Center, Germany
- University Hospital Cologne, Germany
- University of Málaga, Spain
Abstract
Background: Pulse wave velocity independently predicts cardiovascular risk. Easy to use single cuff oscillometric methods are utilized in clinical practice to estimate pulse wave velocity. We applied the approach in master athletes to assess possible beneficial effects of lifelong exercise on vascular health. Furthermore, we compared single cuff measurements with a two-cuff method in another cohort.
Methods: We obtained single cuff upper arm oscillometric measurements thrice in 129 master athletes aged 35 to 86 years and estimated pulse wave velocity using the ArcSolver algorithm. We applied the same method in 24 healthy persons aged 24 to 55 years participating in a head down tilt bedrest study. In the latter group, we also obtained direct pulse wave velocity measurements using a thigh cuff.
Results: Estimated pulse velocity very highly correlated with age (R2 = 0.90) in master athletes. Estimated pulse wave velocity values were located on the same regression line like values obtained in participants of the head down tilt bed rest study. The modest correlation between estimated and measured PWV (r2 0.40; p<0.05) was attenuated after adjusting for age; the mean difference between pulse wave velocity measurements was 1 m/s.
Conclusion: Estimated pulse wave velocity mainly reflects the entered age rather than true vascular properties and, therefore, failed detecting beneficial effects of life long exercise.
Funding: The AGBRESA-Study was funded by the German Aerospace Center (DLR), the European Space Agency (ESA, contract number 4000113871/15/NL/PG) and the National Aeronautics and Space Administration (NASA, contract number 80JSC018P0078). FH received funding by the DLR and the German Federal Ministry of Economy and Technology, BMWi (50WB1816). SM, JT and JJ were supported by the Austrian Federal Ministry for Climate Action, Environment, Energy, Mobility, Innovation and Technology, BMK (SPACE4ALL Project, FFG No. 866761).
Data availability
As we obtained personal health data from human subjects, we cannot make their raw data publicly available. However, an interested researcher is able to access the original data by sending a project proposal to the corresponding author. This project proposal will be reviewed by the medical board of the DLR Institute of Aerospace Medicine. If the project is scientifically valuable, the committee decides to what extent the original data can be made available. Commercial research is excluded from this option. The syntax used for statistical analysis and the numerical data used to generate the figures are stored in Dryad: doi:10.5061/dryad.8931zcrsb#
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Estimated pulse wave velocity is of limited utility to assess vascular stiffnessDryad Digital Repository, doi:10.5061/dryad.8931zcrsb.
Article and author information
Author details
Funding
German Federal Ministry of Economy and Technology (50WB1816)
- Fabian Hoffmann
Austrian Federal Ministry for Climate Action, Environment, Energy, Mobility, Innovation and Technology (FFG No. 866761)
- Stefan Möstl
- Jens Tank
- Jens Jordan
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Human subjects: All subjects provided informed consent and consent to publish before enrollment. The bedrest study as well as the study in master athletes were approved by the Northrine-Medical-Association (Ärztekammer Nordrhein, 2018143 and 2018171) ethics committee and registered at the German Clinical Trial Register (DRKS00015677 and DRKS00015172)
Copyright
© 2022, Möstl et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Utility of estimated pulse wave velocity for assessing vascular stiffness: comparison of methods
eLife 11:e73428.
https://doi.org/10.7554/eLife.73428
Further reading
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It has been well documented that cold is an enhancer of lipid metabolism in peripheral tissues, yet its effect on central nervous system lipid dynamics is underexplored. It is well recognized that cold acclimations enhance adipocyte functions, including white adipose tissue lipid lipolysis and beiging, and brown adipose tissue thermogenesis in mammals. However, it remains unclear whether and how lipid metabolism in the brain is also under the control of ambient temperature. Here, we show that cold exposure predominantly increases the expressions of the lipid lipolysis genes and proteins within the paraventricular nucleus of the hypothalamus (PVH) in male mice. Mechanistically, by using innovatively combined brain-region selective pharmacology and in vivo time-lapse photometry monitoring of lipid metabolism, we find that cold activates cells within the PVH and pharmacological inactivation of cells blunts cold-induced effects on lipid peroxidation, accumulation of lipid droplets, and lipid lipolysis in the PVH. Together, these findings suggest that PVH lipid metabolism is cold sensitive and integral to cold-induced broader regulatory responses.
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Background:
Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a severe and deadly adverse event following ERCP. The ideal method for predicting PEP risk before ERCP has yet to be identified. We aimed to establish a simple PEP risk score model (SuPER model: Support for PEP Reduction) that can be applied before ERCP.
Methods:
This multicenter study enrolled 2074 patients who underwent ERCP. Among them, 1037 patients each were randomly assigned to the development and validation cohorts. In the development cohort, the risk score model for predicting PEP was established via logistic regression analysis. In the validation cohort, the performance of the model was assessed.
Results:
In the development cohort, five PEP risk factors that could be identified before ERCP were extracted and assigned weights according to their respective regression coefficients: –2 points for pancreatic calcification, 1 point for female sex, and 2 points for intraductal papillary mucinous neoplasm, a native papilla of Vater, or the pancreatic duct procedures (treated as ‘planned pancreatic duct procedures’ for calculating the score before ERCP). The PEP occurrence rate was 0% among low-risk patients (≤0 points), 5.5% among moderate-risk patients (1–3 points), and 20.2% among high-risk patients (4–7 points). In the validation cohort, the C statistic of the risk score model was 0.71 (95% CI 0.64–0.78), which was considered acceptable. The PEP risk classification (low, moderate, and high) was a significant predictive factor for PEP that was independent of intraprocedural PEP risk factors (precut sphincterotomy and inadvertent pancreatic duct cannulation) (OR 4.2, 95% CI 2.8–6.3; p<0.01).
Conclusions:
The PEP risk score allows an estimation of the risk of PEP prior to ERCP, regardless of whether the patient has undergone pancreatic duct procedures. This simple risk model, consisting of only five items, may aid in predicting and explaining the risk of PEP before ERCP and in preventing PEP by allowing selection of the appropriate expert endoscopist and useful PEP prophylaxes.
Funding:
No external funding was received for this work.
