Elsevier

Journal of Vascular Surgery

Volume 66, Issue 5, November 2017, Pages 1518-1526
Journal of Vascular Surgery

Clinical research study
Vascular laboratory
Association between arterial stiffness and peripheral artery disease as measured by radial artery tonometry

Presented at the Association for Clinical and Translational Science's Translational Science 2017 conference, Washington, D.C., April 19-21, 2017.
https://doi.org/10.1016/j.jvs.2017.06.068Get rights and content
Under an Elsevier user license
open archive

Abstract

Objective

Arterial stiffness and peripheral artery disease (PAD) are both associated with an elevated risk of major adverse cardiac events; however, the association between arterial stiffness and PAD is less well characterized. The goal of this study was to examine the association between parameters of radial artery tonometry, a noninvasive measure of arterial stiffness, and PAD.

Methods

We conducted a cross-sectional study of 134 vascular surgery outpatients (controls, 33; PAD, 101) using arterial applanation tonometry. Central augmentation index (AIX) normalized to 75 beats/min and peripheral AIX were measured using radial artery pulse wave analysis. Pulse wave velocity was recorded at the carotid and femoral arteries. PAD was defined as symptomatic claudication with an ankle-brachial index of <0.9 or a history of peripheral revascularization. Controls had no history of atherosclerotic vascular disease and an ankle-brachial index ≥0.9.

Results

Among the 126 participants with high-quality tonometry data, compared with controls (n = 33), patients with PAD (n = 93) were older, with higher rates of hypertension, hyperlipidemia, diabetes, and smoking (P < .05). Patients with PAD also had greater arterial stiffness as measured by central AIX, peripheral AIX, and pulse wave velocity (P < .05). In a multivariable model, a significantly increased odds of PAD was associated with each 10-unit increase in central AIX (odds ratio, 2.1; 95% confidence interval, 1.1-3.9; P = .03) and peripheral AIX (odds ratio, 1.9; 95% confidence interval, 1.2-3.2; P = .01). In addition, central and peripheral AIX were highly correlated (r120 = 0.76; P < .001).

Conclusions

In a cross-sectional analysis, arterial stiffness as measured by the AIX is independently associated with PAD, even when adjusting for several atherosclerotic risk factors. Further prospective data are needed to establish whether radial artery tonometry could be a tool for risk stratification in the PAD population.

Cited by (0)

This project was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number TL1 TR001871 with additional student research support from the Society for Vascular Surgery Student Research Fellowship Award and the American Heart Association Student Scholarship (G.J.Z.). Furthermore, this work was supported by start-up funds from the University of California, San Francisco and the Northern California Institute for Research and Education, by Award Number KL2RR024130 from the National Center for Research Resources, Award Number 1K23HL122446-01 from the National Institutes of Health/NHLBI, and a Society for Vascular Surgery Seed Grant and Career Development Award (S.M.G.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health. The funding organizations were not involved in the design and conduct of the study, collection, management, analysis, and interpretation of the data or preparation, review, or approval of the manuscript.

Author conflict of interest: none.

The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a conflict of interest.