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The relationship between aortic augmentation index and pulse wave velocity: an invasive study

Sakurai, Masatoa; Yamakado, Tetsub; Kurachi, Hideshib; Kato, Takaakia; Kuroda, Kenjib; Ishisu, Ryoichib; Okamoto, Shinyab; Isaka, Naokia; Nakano, Takeshia; Ito, Masaakia

doi: 10.1097/HJH.0b013e3280115b7c
Original papers: Blood vessels

Objectives  The aortic augmentation index (AI) and aortic pulse wave velocity (PWV) are known to be indicators of arterial stiffness. However, it is not clear whether aortic AI and PWV reflect aortic stiffness in similar ways. We investigated the relationship between aortic AI and PWV by measuring them directly using a catheter technique.

Design and methods Forty-one patients, aged 34–79 years, were studied during diagnostic cardiac catheterization. Aortic pressures were measured using a catheter-tip manometer at two points, one in the ascending aorta and one 40 cm distally in the descending aorta. Aortic AI was defined as the difference between early and late pressure peaks divided by the pulse pressure of the ascending aorta. Aortic PWV was calculated as the distance between the two measuring sites divided by the transit time. We also examined the effects of vasodilatation on AI and PWV by the intra-aortic administration of nitroglycerin in 15 patients.

Results AI was significantly related to age, systolic aortic pressure, heart rate, left ventricular ejection time, and height. Aortic PWV showed an association only with age and systolic aortic pressure. There was no significant relationship between aortic AI and PWV (r = 0.28, NS). Nitroglycerin also produced different effects on aortic AI and PWV: aortic AI was significantly decreased (−0.17, P < 0.01) after nitroglycerin, but PWV remained unchanged (+0.4 m/s, NS).

Conclusions Aortic AI and PWV cannot be used interchangeably as an index of arterial stiffness. AI may not be a true indicator of arterial stiffness, but an index of wave reflection including PWV.

aDepartment of Cardiology, Mie University of Medicine, Mie, Japan

bDepartment of Cardiology, Nabari City Hospital, Nabari, Mie, Japan

Received 21 October, 2005

Revised 9 September, 2006

Accepted 28 September, 2006

Correspondence and requests for reprints to Tetsu Yamakado, MD, Department of Cardiology, Nabari City Hospital, Yurigaoka Nishi 1-178, Nabari, Mie, Japan Tel: +81 595 61 1100; fax: +81 595 64 7999; e-mail:

Conflict of interest: none.

© 2007 Lippincott Williams & Wilkins, Inc.