1. PULSE WAVE VELOCITY IN VESSELS
38th Aniversary Panhellenic Congress
70 years of Cardiology,
Hellenic Society of Cardiology
PULSE WAVE VELOCITY IN VESSELS
Theodore G. Papaioannou
Associate Professor
Biomedical Engineering Unit, First Department of Cardiology
Medical School, National & Kapodistrian University of Athens

2. Term Stiffness Elasticity Compliance Distensibility Viscoelasticity
Arterial Mechanical Properties
Term
Stiffness
Elasticity
Compliance
Distensibility
Viscoelasticity
Strain

3. Term Stiffness Elasticity Compliance Distensibility Viscoelasticity
Arterial Mechanical Properties
Term
Stiffness
Elasticity
Compliance
Distensibility
Viscoelasticity
Strain

4. Moens–Korteweg equation
Adriaan Isebree Moens
Dutch physician and physiologist
( )
Diederik Johannes Korteweg
Dutch mathematician
( )

5. Pulse wave velocity
Estimation of regional arterial stiffness

6. Pulse wave velocity
Estimation of regional arterial stiffness
Estimation of local arterial stiffness

7. Pulse wave velocity
Estimation of regional arterial stiffness
Estimation of local arterial stiffness
Estimation of total arterial stiffness

8. Arterial stiffness Total Methodological & Technological Advances Local
Regional

9. Devices and techniques
Complior
PoPmetre
CAVI
SphygmoCor Xcel
Vicorder
MobiloGraph ABPM

10. Sensors / Devices for pulse recording Algorithms for signal processing
Advancements
Sensors / Devices for pulse recording
Algorithms for
signal processing

11. Asynchronous, non-simultaneous recordings
Regional arterial stiffness
Asynchronous, non-simultaneous recordings
Pulse Transit Time (PTT)

12. Regional arterial stiffness
Pulse Transit Time (PTT)
Max 1st Derivative
Max 2nd Derivative
Minimum method
Tangential method
Characteristic Points

13. Chiu YC, et al. Am Heart J. 1991; 121: 1460–1470
Foot-to-foot methods for PTT estimation
Chiu YC, et al. Am Heart J. 1991; 121: 1460–1470

14. Absolute difference in PWV (m/sec)
Foot-to-foot methods for PTT estimation
Reproducibility issues …
Absolute difference in PWV (m/sec)
PWV
≤0.25
m/s
0.50 – 0.99
≥1.0
1st – 2nd measure 21
(35%) 19
(31.7%) 9
(15%)
11 (18.3%)
Papaioannou TG, Protogerou A, et al. J Hum Hypertens. 2012;26(10):

15. Foot-to-foot methods for PTT estimation
Tangential Method

16. Foot-to-foot methods for PTT estimation
Validation of a novel and existing algorithms for the estimation of pulse transit time: advancing the accuracy in pulse wave velocity measurement.
Vardoulis O, Papaioannou TG, Stergiopulos N.
Am J Physiol Heart Circ Physiol. 2013; 304:H

17. Foot-to-foot methods for PTT estimation
Validation of a novel and existing algorithms for the estimation of pulse transit time: advancing the accuracy in pulse wave velocity measurement.
Vardoulis O, Papaioannou TG, Stergiopulos N.
Am J Physiol Heart Circ Physiol. 2013; 304:H

18. Foot-to-foot methods for PTT estimation
The “Diastole – Patching” method
Vardoulis O, Papaioannou TG, Stergiopulos N. Am J Physiol Heart Circ Physiol. 2013; 304:H

19. Foot-to-foot methods for PTT estimation
The “Diastole – Patching” method
Vardoulis O, Papaioannou TG, Stergiopulos N. Am J Physiol Heart Circ Physiol. 2013; 304:H

20. Foot-to-foot methods for PTT estimation
The “Diastole – Patching” method in-vivo
Papaioannou TG, Vardoulis O, Protogerou A, et al. Physiol Meas. 2015;36:149-61

21. Foot-to-foot methods for PTT estimation
Accuracy and Precision of PWV measurement
Clinical value of PWV
???

22. “Heart rate variability” 21.837 papers
“c reactive protein” papers

23. Measurements issues - Consensus Documents
Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity.
Van Bortel L, et al. J Hypertens. 2012; 30(3):445-8.
Expert consensus document on arterial stiffness: Methodological issues and clinical applications.
Laurent S, et al. Eur. Heart J. 2006; 27:

24. Normal and Reference Values of PWV
Eur Heart J Oct;31(19):

25. 25

26. PWV and cardiovascular risk
Ben-Shlomo et al, JACC; 2014; 63:

27. The main finding of the current study is that aortic stiffness, assessed by measurement of aPWV, can predict future cardiovascular events and mortality, even after accounting for other established cardiovascular risk factors. The predictive value of aPWV was stronger in younger versus older subjects but was not modified by hypertension, smoking, sex, diabetes, or kidney disease. Addition of aPWV into risk prediction models also increased the number of participants who were correctly classified, particularly among younger individuals at intermediate risk, and it improved the overall 10-year classification by 13%.
Ben-Shlomo et al, JACC; 2014; 63:

28. Guidelines

29. Thank you
Étienne-Jules Marey (1863)