Development and Validation of a Path Length Calculation for Carotid-Femoral Pulse Wave Velocity Measurement: A TASCFORCE, SUMMIT, and Caerphilly Collaborative Venture

Jonathan R Weir-McCall; Liam Brown; Jennifer Summersgill; Piotr Talarczyk; Michael Bonnici-Mallia; Sook C Chin; Faisel Khan; Allan D Struthers; Frank Sullivan; Helen M Colhoun; Angela C Shore; Kunihiko Aizawa; Leif Groop; Jan Nilsson; John R Cockcroft; Carmel M McEniery; Ian B Wilkinson; Yoav Ben-Shlomo; J Graeme Houston

doi:10.1161/HYPERTENSIONAHA.117.10620

Development and Validation of a Path Length Calculation for Carotid-Femoral Pulse Wave Velocity Measurement: A TASCFORCE, SUMMIT, and Caerphilly Collaborative Venture

Hypertension. 2018 May;71(5):937-945. doi: 10.1161/HYPERTENSIONAHA.117.10620. Epub 2018 Mar 19.

Authors

Jonathan R Weir-McCall¹, Liam Brown¹, Jennifer Summersgill¹, Piotr Talarczyk¹, Michael Bonnici-Mallia¹, Sook C Chin¹, Faisel Khan¹, Allan D Struthers¹, Frank Sullivan¹, Helen M Colhoun¹, Angela C Shore¹, Kunihiko Aizawa¹, Leif Groop¹, Jan Nilsson¹, John R Cockcroft¹, Carmel M McEniery¹, Ian B Wilkinson¹, Yoav Ben-Shlomo¹, J Graeme Houston²

Affiliations

¹ From the Division of Molecular and Clinical Medicine, College of Medicine, University of Dundee, United Kingdom (J.R.W.-M., L.B., J.S., F.K., A.D.S., J.G.H.); NHS Tayside Clinical Radiology, Ninewells Hospital, Dundee, United Kingdom (P.T., M.B.-M., S.C.C.); Department of Research and Innovation, North York General Hospital, University of Toronto, Canada (F.S.); Centre for Genomic and Experimental Medicine, The University of Edinburgh, Western General Hospital, United Kingdom (H.M.C.); NIHR Exeter Clinical Research Facility, Royal Devon and Exeter Hospital and University of Exeter Medical School, United Kingdom (A.C.S., K.A.); Lund University Diabetes Centre, Lund University, Malmö, Sweden (L.G.); Department of Clinical Sciences Malmö, Lund University, Sweden (J.N.); Department of Cardiology, Wales Heart Research Institute, Cardiff, United Kingdom (J.R.C.); Division of Experimental Medicine & Immunotherapeutics, University of Cambridge, United Kingdom (C.M.M., I.B.W.); and Population Health Sciences, University of Bristol, United Kingdom (Y.B.-S.).
² From the Division of Molecular and Clinical Medicine, College of Medicine, University of Dundee, United Kingdom (J.R.W.-M., L.B., J.S., F.K., A.D.S., J.G.H.); NHS Tayside Clinical Radiology, Ninewells Hospital, Dundee, United Kingdom (P.T., M.B.-M., S.C.C.); Department of Research and Innovation, North York General Hospital, University of Toronto, Canada (F.S.); Centre for Genomic and Experimental Medicine, The University of Edinburgh, Western General Hospital, United Kingdom (H.M.C.); NIHR Exeter Clinical Research Facility, Royal Devon and Exeter Hospital and University of Exeter Medical School, United Kingdom (A.C.S., K.A.); Lund University Diabetes Centre, Lund University, Malmö, Sweden (L.G.); Department of Clinical Sciences Malmö, Lund University, Sweden (J.N.); Department of Cardiology, Wales Heart Research Institute, Cardiff, United Kingdom (J.R.C.); Division of Experimental Medicine & Immunotherapeutics, University of Cambridge, United Kingdom (C.M.M., I.B.W.); and Population Health Sciences, University of Bristol, United Kingdom (Y.B.-S.). j.g.houston@dundee.ac.uk.

Abstract

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.

Keywords: arteriosclerosis; atherosclerosis; cardiovascular diseases; hypertension; magnetic resonance angiography; pulse wave analysis.

Publication types

Comparative Study
Multicenter Study
Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Adult
Age Factors
Aged
Analysis of Variance
Blood Flow Velocity / physiology*
Blood Pressure / physiology*
Blood Pressure Determination / methods
Carotid Arteries / diagnostic imaging
Carotid Arteries / physiology
Cohort Studies
Female
Femoral Artery / diagnostic imaging
Femoral Artery / physiology
Humans
Logistic Models
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Prospective Studies
Pulse Wave Analysis / methods*
Risk Assessment
Sex Factors
Vascular Stiffness*
Whole Body Imaging

Abstract

Publication types

MeSH terms

Grants and funding