Influence of the central-to-peripheral arterial stiffness gradient on the timing and amplitude of wave reflections
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Authors
Hickson, Stacey S
Nichols, Wilmer W
Yasmin
McDonnell, Barry J
Cockcroft, John R
Wilkinson, Ian B
McEniery, Carmel M
Publication Date
2016Journal Title
HYPERTENSION RESEARCH
ISSN
0916-9636
Publisher
Japanese Society of Hypertension
Volume
39
Issue
10
Pages
723-729
Type
Article
Metadata
Show full item recordCitation
Hickson, S. S., Nichols, W. W., Yasmin, McDonnell, B. J., Cockcroft, J. R., Wilkinson, I. B., & McEniery, C. M. (2016). Influence of the central-to-peripheral arterial stiffness gradient on the timing and amplitude of wave reflections. HYPERTENSION RESEARCH, 39 (10), 723-729. https://doi.org/10.1038/hr.2016.64
Abstract
In individuals with compliant aortas, peripheral muscular artery stiffness exceeds central elastic artery stiffness. With ageing, central stiffness increases, with little change in peripheral stiffness, resulting in a reversal of the normal stiffness gradient. This reversal may reduce wave reflection amplitude, due to movement of the major “effective” reflection site further from the heart. To test this, we investigated the relationship among arterial stiffness gradients (normal and reversed), wave reflection amplitude and reflection site distance.
Subjects aged ≥50years were recruited from the Anglo-Cardiff Collaborative Trial. Central stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). In study 1, peripheral PWV was also measured in the arm (carotid-radial, crPWV), and in study 2 in the leg (femoral- dorsalis pedis, fpPWV). Reflection site distance was calculated from cfPWV and reflected wave travel time. Subjects were dichotomized into those with a normal stiffness gradient (peripheral>central PWV), or a reversed gradient (peripheral<central PWV).
In study 1, reflection site distance was greater in subjects with a reversed gradient (P<0.01), whereas time to reflection was lower (P<0.001). Both augmentation pressure (P<0.001) and augmentation index (P<0.05) were greater in subjects with a reversed gradient. In study 2, augmentation pressure, augmentation index and reflection site distance were greater in subjects with a reversed stiffness gradient (P<0.01, P<0.05 and P<0.01, respectively), and time to reflection was not different between groups.
A reversed arterial stiffness gradient is associated with increased reflection site distance and a paradoxical increase in reflected wave amplitude, and augmentation index.
Keywords
arterial stiffness gradient, augmentation index, central pulse pressure, pulse wave velocity, wave reflection
Sponsorship
British Heart Foundation (None)
NIHR Clinical Research Network Eastern (via Cambridge University Hospitals NHS Foundation Trust (CUH))
Identifiers
External DOI: https://doi.org/10.1038/hr.2016.64
This record's URL: https://www.repository.cam.ac.uk/handle/1810/285735
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