Arteriograph 心不全・突然死・脳卒中などの予診の検証が正確で3分間で結果が得られる世紀の発明との評価が多く報告されてきた

 HypertensionVolume 77, Issue 2, February 2021; Pages 571-581

https://doi.org/10.1161/HYPERTENSIONAHA.120.15336

ATERIAL STIFFNESS

Aortic Pulse Wave Velocity Predicts Cardiovascular Events and 

Mortality in Patients Undergoing Coronary Angiography

A Comparison of Invasive Measurements and Noninvasive Estimates

Bernhard Hametner, Siegfried Wassertheurer, Christopher Clemens Mayer, 

Kathrin Danninger, Ronald K. Binder, and Thomas Weber

ABSTRACTAortic pulse wave velocity (PWV) is directly related to arterial stiffness.

 Different methods for the determination of PWV coexist. 

The aim of this prospective study was to evaluate the prognostic value of

 PWV in high-risk patients with suspected coronary artery disease

 undergoing invasive angiography and to compare 3 different methods 

for assessing PWV. In 1040 patients, 

invasive PWV (iPWV) was measured during catheter pullback. 

Additionally, PWV was estimated with a model incorporating age,

 central systolic blood pressure, and 

pulse waveform characteristics obtained 

from noninvasive measurements (estimated PWV).

 As a third method, PWV was calculated 

with a formula solely based on age and blood pressure

 (formula-based PWV). Survival analysis 

was based on continuous PWV as well as using cutoff values.

 After a median follow-up duration of 1565 days, 

24% of the patients reached the combined end point 

(cardiovascular events or mortality). 

Cox proportional hazard ratios per 1 SD were 1.35 for iPWV, 1.37

for estimated PWV, and 1.28 for formula-based PWV (P<0.0001 

for all 3 methods) in univariate analysis, 

remaining statistically significant after comprehensive multivariable adjustments. 

In a model including a modified risk score for coronary artery disease, iPWV

 and estimated PWV remained borderline significant. 

The net reclassification improvement was significant for iPWV (0.173),

 formula-based PWV (0.181), and estimated PWV (0.230). 

All 3 methods for the determination of PWV predicted cardiovascular events

 and mortality in patients with suspected coronary artery disease. 

This indicates that iPWV as well as both noninvasive estimation methods

 are suitable for the assessment of arterial stiffness, 

bearing in mind their individual characteristics.