P143 VALIDITY OF PULSE WAVE VELOCITY AND AUGMENTATION INDEX MEASUREMENTS IN PATIENTS WITH ATRIAL FIBRILLATION

DOI

10.1016/j.artres.2017.10.155How to use a DOI?

Abstract

Background: Individualized weighing of the risk-benefit of anticoagulation is recommended in patients with atrial fibrillation (AF) that have low established risk scores or, conversely, are at increased risk for bleeding¹. Parameters of arterial stiffness and wave reflection could improve risk stratification, but their use has not been validated in arrhythmia^2–3.

Methods: We measured carotid-femoral pulse wave velocity (PWV), central augmentation index (AI) and central pulse pressure (CPP) using the SphygmoCor (AtCor Medical, Sydney, Australia) system in 34 patients (53 to 85 years; 25 males) with AF before and after elective electrical cardioversion. Agreement was assessed using the intraclass correlation coefficient (ICC) and the coefficient of variation, completed with Bland-Altman plots.

Results: Following cardioversion, mean arterial blood pressure (MAP) and heart rate (HR) decreased significantly by 7 mmHg and 18 bpm respectively. PWV decreased from 11.8 m/s to 10.7 m/s, AI increased from 24% to 29%, and CPP rose from 45 mmHg to 50 mmHg. The decrease in PWV was related to the decrease in MAP (beta = 0.57; R² = 0.33; P < 0.001) whereas changes in AI and CPP were related to the decrease in HR (AI: beta = −0.59; R² = 0.35; P < 0.001, CPP: beta = −0.52; R² = 0.26; P = 0.001).

After adjustment for changes in MAP and HR, reliability analysis showed an excellent agreement for PWV (ICC = 0.89; 95%CI: 0.79–0.95) but moderate agreement for AI (ICC = 0.59; 95%CI: 0.17–0.80). Excellent agreement was also found for CPP (ICC = 0.89; 95%CI: 0.78–0.94).

Figure 1.

A. Scatter plot showing PWV before (PWV_t0) and after (PWV_t1) cardioversion. The solid line Is the Ihie of identity, the broken line the regression line for PWV_t1 vs PW_t0 (Passini & Bablok regression). B. Bland-Altman plot showing the proportional difference (%) between P∖) between PWV after (PVW_t1) and PWV before (PWV_t0) cardioversion. The solid line represents the mean value ot PWV and the dotted lines mean ± 2 SD.

Figure 2.

A. Scatter plot showing Al before (Al_t0) and after (Al_t1) cardioversion. The solid line is the line of identity, the broken line the regression line for Al_t1 vs Al_t0 (Passing & Bablok regression). B. Bland-Altman plot showing the proportional difference (%) between Al after (Al_t1) and Al before (Al_t0) cardioversion. The solid line represents the mean value of Al and the dotted lines mean±2 SD.

Conclusions: Measurement of PWV and CPP is reliable in patients with AF, as they appear unaffected by the presence of arrhythmia.

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TY  - JOUR
AU  - Rogier Caluwe
AU  - An S. De Vriese
AU  - Bruno Van Vlem
AU  - Francis Verbeke
PY  - 2017
DA  - 2017/12/06
TI  - P143 VALIDITY OF PULSE WAVE VELOCITY AND AUGMENTATION INDEX MEASUREMENTS IN PATIENTS WITH ATRIAL FIBRILLATION
JO  - Artery Research
SP  - 96
EP  - 97
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.155
DO  - 10.1016/j.artres.2017.10.155
ID  - Caluwe2017
ER  -