The validity of carotid-femoral pulse wave velocity in the seated posture as an index of central arterial stiffness.

IF 2.2 3区 医学 Q3 PHYSIOLOGY
Marino Karaki, Narumi Kunimatsu, Kohei Watanabe, Tsubasa Tomoto, Marina Fukuie, Jun Sugawara, Shigehiko Ogoh
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Abstract

A previous study reported an increase in carotid-femoral pulse wave velocity (cfPWV) during an upright posture compared to the supine position, partly due to sympathetic activation. However, given that cfPWV is influenced by the transmural pressure (TMP) of the artery, which is elevated in the abdominal aorta in the seated posture due to the increased hydrostatic pressure. Thus, it remains unclear whether this increased cfPWV reflects a true rise in arterial stiffness or is simply a result of the elevated TMP. To assess the validity of cfPWV in the seated posture for arterial stiffness assessment, 20 young healthy subjects underwent arterial stiffness measurements in both the supine and seated positions. There were no significant differences in carotid artery compliance, β-stiffness index, and aortic characteristic impedance between the two positions (P = 0.209-0.380). However, cfPWV was higher in the seated posture than the supine posture (5.4 ± 0.6 vs. 6.2 ± 0.8 m/s, P < 0.0001), showing a high intraclass correlation coefficient (ICC) between positions (r = 0.841, P < 0.0001) and a parallel upward shift by 14% (y = 1.01x + 0.54). Moreover, cfPWV was correlated with TMP at the groin level (r = 0.532, P = 0.0004), and after adjusting for TMP at the groin level using analysis of covariance (ANCOVA), the posture-related difference in cfPWV was no longer significant (P = 0.867). These findings suggest that the increase in cfPWV observed in the seated posture is primarily due to elevated TMP caused by increased hydrostatic pressure, rather than a genuine rise in arterial stiffness. Consequently, cfPWV measurements taken in the seated posture may overestimate arterial stiffness unless they are appropriately adjusted for TMP.NEW & NOTEWORTHY This study demonstrated for the first time that the increase in carotid-femoral pulse wave velocity (cfPWV) observed in the seated posture is likely due to elevated transmural pressure (TMP) caused by increased hydrostatic pressure, rather than an actual rise in central arterial stiffness. Intraclass correlation analysis also showed a parallel upward shift in the regression line between supine and seated postures. This suggests that cfPWV values obtained in the seated position should be adjusted for hydrostatic pressure and TMP.

坐姿下颈动脉-股动脉脉搏波速度作为中心动脉僵硬度指标的有效性。
先前的一项研究报道,与仰卧位相比,直立姿势时颈-股脉波速度(cfPWV)增加,部分原因是交感神经激活。然而,考虑到cfPWV受动脉跨壁压力(TMP)的影响,在坐姿时,由于静水压力增加,腹主动脉的跨壁压力升高。因此,目前尚不清楚cfPWV的增加是否反映了动脉僵硬度的真正上升,还是仅仅是TMP升高的结果。为了评估cfPWV在坐姿动脉硬度评估中的有效性,20名年轻健康受试者分别在仰卧位和坐姿进行了动脉硬度测量。两种体位颈动脉顺应性、β-刚度指数、主动脉特征阻抗差异无统计学意义(P=0.209~0.380)。然而,与仰卧位相比,坐姿的cfPWV更高(5.4±0.6比6.2±0.8 m/s, P
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来源期刊
CiteScore
5.30
自引率
3.60%
发文量
145
审稿时长
2 months
期刊介绍: The American Journal of Physiology-Regulatory, Integrative and Comparative Physiology publishes original investigations that illuminate normal or abnormal regulation and integration of physiological mechanisms at all levels of biological organization, ranging from molecules to humans, including clinical investigations. Major areas of emphasis include regulation in genetically modified animals; model organisms; development and tissue plasticity; neurohumoral control of circulation and hypertension; local control of circulation; cardiac and renal integration; thirst and volume, electrolyte homeostasis; glucose homeostasis and energy balance; appetite and obesity; inflammation and cytokines; integrative physiology of pregnancy-parturition-lactation; and thermoregulation and adaptations to exercise and environmental stress.
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