Development and Validation of a Path Length Calculation for Carotid–Femoral Pulse Wave Velocity Measurement

摘要

Current distance measurement techniques for pulse wave velocity (PWV) calculation are susceptible to intercentervariability. The aim of this study was to derive and validate a formula for this distance measurement. Based on carotid femoraldistance in 1183 whole-body magnetic resonance angiograms, a formula was derived for calculating distance. This wascompared with distance measurements in 128 whole-body magnetic resonance angiograms from a second study. The effectsof recalculation of PWV using the new formula on association with risk factors, disease discrimination, and prediction ofmajor adverse cardiovascular events were examined within 1242 participants from the multicenter SUMMIT study (SurrogateMarkers of Micro- and Macrovascular Hard End-Points for Innovative Diabetes Tools) and 825 participants from theCaerphilly Prospective Study. The distance formula yielded a mean error of 7.8 mm (limits of agreement =?41.1 to 56.7 mm;P<0.001) compared with the second whole-body magnetic resonance angiogram group. Compared with an external distancemeasurement, the distance formula did not change associations between PWV and age, blood pressure, or creatinine (P<0.01)but did remove significant associations between PWV and body mass index (BMI). After accounting for differences in age,sex, and mean arterial pressure, intercenter differences in PWV persisted using the external distance measurement (F=4.6;P=0.004), whereas there was a loss of between center difference using the distance formula (F=1.4; P=0.24). PWV odds ratiosfor cardiovascular mortality remained the same using both the external distance measurement (1.14; 95% confidence interval,1.06–1.24; P=0.001) and the distance formula (1.17; 95% confidence interval, 1.08–1.28; P<0.001). A population-derivedautomatic distance calculation for PWV obtained from routinely collected clinical information is accurate and removesintercenter measurement variability without impacting the diagnostic utility of carotid–femoral PWV.