Development and validation of a path length calculation for carotid–femoral pulse wave velocity measurement. A TASCFORCE, SUMMIT, and Caerphilly collaborative venture
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Current distance measurement techniques for pulse wave velocity (PWV) calculation are susceptible to intercenter variability. The aim of this study was to derive and validate a formula for this distance measurement. Based on carotid femoral distance in 1183 whole-body magnetic resonance angiograms, a formula was derived for calculating distance. This was compared with distance measurements in 128 whole-body magnetic resonance angiograms from a second study. The effects of recalculation of PWV using the new formula on association with risk factors, disease discrimination, and prediction of major adverse cardiovascular events were examined within 1242 participants from the multicenter SUMMIT study (Surrogate Markers of Micro- and Macrovascular Hard End-Points for Innovative Diabetes Tools) and 825 participants from the Caerphilly 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 distance measurement, 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 ratios for 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-derived automatic distance calculation for PWV obtained from routinely collected clinical information is accurate and removes intercenter measurement variability without impacting the diagnostic utility of carotid–femoral PWV.
Weir-McCall , J R , Brown , L , Summersgill , J , Talarczyk , P , Bonnici-Mallia , M , Chin , S C , Khan , F , Struthers , A D , Sullivan , F , Colhoun , H M , Shore , A C , Aizawa , K , Groop , L , Nilsson , J , Cockcroft , J R , McEniery , C M , Wilkinson , I B , Ben-Shlomo , Y & Houston , J G 2018 , ' Development and validation of a path length calculation for carotid–femoral pulse wave velocity measurement. A TASCFORCE, SUMMIT, and Caerphilly collaborative venture ' , Hypertension , vol. 71 , no. 5 , pp. 937–945 . https://doi.org/10.1161/HYPERTENSIONAHA.117.10620
© 2018 The Authors. Hypertension is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.
DescriptionThe TASCFORCE study (Tayside Screening for Cardiovascular Events) was funded by the Souter Charitable Foundation and the Chest, Heart and Stroke Scotland Charity. The SUMMIT study (Surrogate Markers of Micro- and Macrovascular Hard End-Points for Innovative Diabetes Tools) was supported by the Innovative Medicines Initiative (the SUMMIT consortium, IMI-2008/115006). The initial stages of the CaPS (Caerphilly Prospective Study) was funded by the MRC with a grant from the British Heart Foundation funding the measurement of the pulse wave velocity. The statistician was funded by TENOVUS, Tayside. J.R. Weir-McCall is supported by the Wellcome Trust through the Scottish Translational Medicine and Therapeutics Initiative (Grant no. WT 085664) in the form of a Clinical Research Fellowship. C.M. McEniery is supported by the NIHR (National Institute of Health Research) Cambridge Biomedical Research Centre.
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