The comparison of pulsed wave velocity measured with oscillometric method and transthoracic Doppler echocardiography in patients with wide range of cardiovascular risk
Authors: Wierzbowska-Drabik K , Mozdzan M , Balcerak M , Kilarska M , Pawlos A , Gorzelak-Pabis P , Witkowska A , Bala A , Staciwa M , Broncel M , Mozdzan Z , Wozniak E , Broncel A 
Published: January 2025

Abstract

Background
Pulse Wave Velocity (PWV) is an important parameter in assessing arterial stiffness and potent predictor of cardiovascular risk, however its clinical usage remains limited. Whereas there is a range of dedicated devices (based on oscillometric or tonometric methods) the inclusion of PWV evaluation to transthoracic echocardiography (TTE) may increase significally its application.

Purpose
Our aim was to compare PWV measured with oscillometry signed as aPWV with this parameter measured by TTE, signed as ePWV during one examination (within 15 minutes time) and to evaluate the correlations of these parameters with clinical and echocardiographic characteristics.

Methods
We included 56 patients (mean age 55 years; 65% female), who underwent both TTE with Doppler examination of flow in carotid and femoral artery and ePWV calculation as well as oscillometric measurement of aPVW in the right brachial artery. ePWV was calculated using Doppler spectra registered in the both carotid and femoral arteries as well as a distance between points of measurements as the distance divided by estimated pulse wave transit time (achieved with simultaneous ECG recording). Studied group was divided into low and high cardiovascular risk category according SCORE2 scale for the primary prevention. As a low risk group, LR, we accepted those with score ≤5% including to HR group also secondary prevention patients (high risk group, HR).

Results
Oscillometric measurements were obtained in 50 patients (aPWV feasibility 89%) and Doppler parameters in all patients (ePWV feasibility 100%). Intra- and interobserver agreement was good for all measurements with coefficients of variation &lt; 15%. PWV parameters, measured by both methods, showed a significant positive correlation with rho = 0.675, p&lt;0.0001 as well as a good discriminatory potential between LR and HR groups (Figure 1). The HR group was older had faster PWV as well as higher LAV, E/E' and IMT values and lower TAPSE (see Table). Moreover, significant correlation between ePWV value and carotid IMT was observed with coefficient rho = 0.576, p = 0.0017, whereas this correlation achieved rho = 0.419, p=0.047 for aPWV.

Conclusions
ePWV based on Doppler echocardiography is a safe and highly feasible method of PWV measurement, showing good correlation with oscillometric assessment and providing data reflecting well cardiovascular risk as well as IMT of carotid arteries.
Table. Comparison between LR and HR groups.
Table Legend: T (R-flow) – time from R wave to Doppler spectrum of flow, ePWV or aPWV – pulsed wave velocity assessed with echocardiography or automatically, IMT- intima media thickness, LAV- left atrial volume, E/E’ - early mitral inflow to early mitral annulus motion ratio, LV EF, left ventricular ejection fraction, FAC – fractional area change of the right ventricle, TAPSE- tricuspid annulus plane systolic motion, RV S’ – tricuspid annulus systolic motion with tissue Doppler imaging.
aPWV with ePWV correlation in LR and HR
Table. Comparison of LR and HR groups