Influence of carotid atherosclerotic plaques on pulse wave assessment with arterial tonometry : Journal of Hypertension

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ORIGINAL PAPERS: Blood vessels

Influence of carotid atherosclerotic plaques on pulse wave assessment with arterial tonometry

Grillo, Andreaa,b,*; Simon, Giuliac,*; Salvi, Paolob; Rovina, Matteoc; Baldi, Corradoc; Prearo, Ilariac; Bernardi, Stellac; Fabris, Brunoc; Faini, Andreab; Parati, Gianfrancoa,b; Bardelli, Morenoc; Carretta, Renzoc

Author Information

aDepartment of Medicine and Surgery, University of Milano-Bicocca

bDepartment of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan

cDepartment of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy

*Andrea Grillo and Giulia Simon contributed equally to the article.

Correspondence to Renzo Carretta, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy; U.C.O. Medicina Clinica, Ospedale di Cattinara, Strada di Fiume, 447, 34149 Trieste, Italy. Tel: +39 040 399 4318; fax: +39 040 399 4912; e-mail: [email protected]

Abbreviations: AIx, augmentation index; AIx@75, augmentation index normalized for heart rate of 75 bpm; BP, blood pressure; ICC, intraclass correlation coefficient; IMT, carotid intima–media thickness; Pb, amplitude of the backward pulse wave; Pf, amplitude of the forward pulse wave; PWV, carotid–femoral pulse wave velocity

Received 23 September, 2016

Revised 16 February, 2017

Accepted 10 March, 2017

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.jhypertension.com).

Journal of Hypertension 35(8):p 1609-1617, August 2017. | DOI: 10.1097/HJH.0000000000001366

Abstract

Objective: 

Aortic stiffness and central pressure measurements have become increasingly important for the overall estimation of cardiovascular risk. The aim of this study is to verify whether the presence of stenosis in the carotid arteries due to atherosclerotic plaques may induce a bias in the measurement of carotid–femoral pulse wave velocity (PWV) and in the analysis of central pulse waveform variables assessed by carotid tonometry.

Methods: 

Eighty-four patients (age: 67.1 ± 12.4 years) undergoing screening for carotid atherosclerosis were enrolled, divided into three groups according to carotid ultrasound findings (NASCET criteria): 28 patients without significant stenosis, 30 patients with bilateral plaques, and 26 patients with right or left monolateral stenosis. PWV and other variables derived from the central pulse waveform analysis (central blood pressure, augmentation index and forward and backward waves) were measured at both right and left carotid arteries by a validated PulsePen tonometer. A repeatability study was performed in 28 young healthy patients (age: 25.4 ± 2.9 years).

Results: 

A high degree of correlation was found between bilateral measurements in all groups, and particularly in groups with monolateral carotid stenosis, with no significant difference attributable to lateralized stenosis. Right–left differences in asymmetric groups were 0.35 ± 5.12 mmHg (R2 = 0.960) for central blood pressure, −2.12 ± 7.39% (R2 = 0.743) for augmentation index, 0.64 ± 1.56 m/s (R2 = 0.947) for PWV, 0.08 ± 8.48 mmHg for forward wave (R2 = 0.742) and 0.35 ± 2.35 mmHg for backward wave (R2 = 0.907).

Conclusion: 

Measurement of PWV and of variables derived from the central pulse waveform analysis by carotid tonometry is not biased by the presence of local atherosclerotic plaques.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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