Age-specific reference values for carotid arterial stiffness estimated by ultrasonic wall tracking

Interaction between arterial stiffness and hypertension plays an important role in the development of cardiovascular disease. Accordingly, assessment of arterial stiffness may provide a tool for estimating cardiovascular risk and monitoring therapy in hypertensive patients. Radiofrequency-based vasc...

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Bibliographic Details
Published in:Journal of human hypertension 2020-03, Vol.34 (3), p.214-222
Main Authors: Uejima, Tokuhisa, Dunstan, Frank D, Arbustini, Eloisa, Łoboz-Grudzień, Krystyna, Hughes, Alun D, Carerj, Scipione, Favalli, Valentina, Antonini-Canterin, Francesco, Vriz, Olga, Vinereanu, Dragos, Zamorano, Jose L, Popescu, Bogdan A, Evangelista, Arturo, Lancellotti, Patrizio, Lefthériotis, Georges, Kozakova, Michaela, Palombo, Carlo, Fraser, Alan G
Format: Article
Language:English
Subjects:
Age
Aging
Blood pressure
Cardiovascular & respiratory systems
Cardiovascular diseases
Carotid artery
Demographic aspects
Echocardiography
Gender
Health aspects
Human health sciences
Mathematical models
Mechanical properties
Medical examination
Nomograms
Patients
Sciences de la santé humaine
Statistical analysis
Systèmes cardiovasculaire & respiratoire
Ultrasound
Vascular resistance
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Summary:Interaction between arterial stiffness and hypertension plays an important role in the development of cardiovascular disease. Accordingly, assessment of arterial stiffness may provide a tool for estimating cardiovascular risk and monitoring therapy in hypertensive patients. Radiofrequency-based vascular ultrasound allows accurate noninvasive assessment of local mechanical properties of large arteries, but for its use in clinical practice, reference values according to age and sex are mandatory for each vascular site. To provide reference values for common carotid artery stiffness as assessed by an echo-tracking imaging system Hitachi-Aloka, we pooled measurements collected in 1847 healthy subjects aged 3-74 years (1008 males and 839 females) recruited in 14 European centers in the E-tracking International Collaboration (ETIC). Statistical models were developed to describe relationships of different stiffness indices with age and to calculate median values and Z-scores corresponding to ± 1 and ± 2 standard deviations. In our apparently healthy population, age accounted for 53% of variability in the elastic modulus (epsilon), 39% in arterial compliance, 47% in stiffness index (β), and 56% in local pulse wave velocity; on average, blood pressure accounted for a further 7.5% of variability. Dependence on age was not linear; changes in mean values increased at older ages, especially for epsilon and β. There was an interaction between age and gender for arterial compliance, which was higher in males. We present nomograms and a software that can be used for the automated calculation of Z-scores for local carotid stiffness in individual patients. These tools can be used to establish prognostic indicators or surrogate targets for treatment monitoring.
ISSN:0950-9240
1476-5527
DOI:10.1038/s41371-019-0228-5