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P2.12 Influence of the Central to Peripheral Arterial Stiffness Gradient on Timing and Amplitude of Wave Reflections
Artery Research volume 2, page 109 (2008)
Abstract
In younger individuals peripheral muscular arteries are stiffer and pulse wave velocity (PWVm) greater than central elastic artery stiffness and PWVe (PWVm>PWVe). The marked increase in aortic stiffness with age, with little change in peripheral stiffness, results in a reversal of the arterial stiffness gradient (PWVe>PWVm). It has been hypothesized1 that this may reduce wave reflection amplitude and augmentation index (AIa) due to movement of the major reflection site further from the heart. To test this hypothesis we investigated whether a reverse stiffness gradient (PWVe >PWVm) is associated with a reduced AIa and an increased reflection site distance.
Studies were performed in subjects aged>50 years who were free of medication. Following 10mins supine rest, blood pressure, pulse wave analysis and carotid-femoral (PWVe) and femoral-dorsalis-pedis (PWVm) PWVs were measured. Distance to the major reflection site was calculated from PWVe and reflected wave travel time (Tr/2)2.
PWVe and PWVm were 7.8±1.0m/s and 9.7±1.0m/s, respectively, in subjects with a positive stiffness gradient (PWVm>PWVe) and 10.8±2.1m/s and 9.0±1.6m/s in subjects with a reverse stiffness gradient. Central pulse pressure and augmentation pressure were higher in subjects with a reverse stiffness gradient (38 ± 18vs.48±9mmHg and 12±6vs.14±5mmHg, P<0.05), as was AIa corrected for heart rate (23±8vs.27±6%.P<0.05) and reflection site distance (56±10vs.76±15cm. P<0.01). Time to reflection did not differ between groups (71.4±6.4vs.70.5±5.0ms).
Reversal of the stiffness gradient (PWVe>PWVm) is associated with increased central pulse pressure, reflected wave amplitude and AIa and a paradoxical increase in reflection site distance.
References
Mitchell GF et al. Hypertension. 2004;43:1239–45.
Murgo JP et al. Circulation. 1980;62:105–16.
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Hickson, S., Nichols, W., Wilkinson, I. et al. P2.12 Influence of the Central to Peripheral Arterial Stiffness Gradient on Timing and Amplitude of Wave Reflections. Artery Res 2, 109 (2008). https://doi.org/10.1016/j.artres.2008.08.378
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DOI: https://doi.org/10.1016/j.artres.2008.08.378