P.066 Peripheral Vascular Disease is Associated with Increased Aortic Stiffness

Abstract

Objective

Aortic pulse wave velocity (aPWV) is a powerful and independent predictor of all cause cardiovascular mortality. Patients with peripheral vascular disease (PVD) are at a higher risk of cardiovascular events. We hypothesized that patients with PVD would have a higher aPWV than age-matched healthy controls, and that aPWV would be inversely related to ankle brachial pressure index (APBI).

Methods

We studied 212 patients with PVD (mean age 71 ± 9 years, 68% male) with a mean ABPI of 0.64 ± 0.16 and 455 age-matched controls (mean age 70 ± 7 years, 64% male). Aortic augmentation index (AIx) augmentation pressure (AP) and central blood pressure were determined by pulse wave analysis using the SphygmoCor^® system. PWV was derived using sequential carotid to femoral waveform recordings for aPWV and carotid and radial waveforms for brachial PWV.

Results

aPWV was significantly higher in patients with PVD compared with age-matched controls. (11.7 ± 3.5 vs. 9.9 ± 2.6m/s, P<0.0001). Both peripheral and central, systolic and pulse pressures were significantly higher in the PVD group compared to age-matched controls. AP was higher in the PVD group (19 ± 10 vs. 14 ± 7mmHg) but AIx was not. The difference in aPWV persisted after correction for mean arterial pressure (10.57 ± r 2.31vs. 9.02 ± r 3.46, P<0.0001). In regression model, age, mean pressure, diabetes and previous myocardial infarction predicted aPWV(r = 0.6, p<0.001). aPWV was inversely associated with ABPI (R² = -0.19, P<0.0001).

Conclusions

The increased aortic stiffness provides a possible explanation for the increased cardiovascular events seen in PVD patients but exact mechanisms underlying this need to be addressed.