Impedance plethysmography-based method in the assessment of subclinical atherosclerosis

Mira Haapala; Leo-Pekka Lyytikäinen; Mikko Peltokangas; Teemu Koivistoinen; Nina Hutri-Kähönen; Mika-Matti Laurila; Matti Mäntysalo; Olli T Raitakari; Mika Kähönen; Terho Lehtimäki; Antti Vehkaoja; Niku Oksala

doi:10.1016/j.atherosclerosis.2021.01.006

Impedance plethysmography-based method in the assessment of subclinical atherosclerosis

Atherosclerosis. 2021 Feb:319:101-107. doi: 10.1016/j.atherosclerosis.2021.01.006. Epub 2021 Jan 12.

Affiliations

¹ Finnish Cardiovascular Research Center - Tampere, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland; Faculty of Medicine and Health Technology, Arvo Ylpön Katu 34 (33520 Tampere) P.O. Box 100, FI-33014 Tampere University, Finland.
² Finnish Cardiovascular Research Center - Tampere, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland; Faculty of Medicine and Health Technology, Arvo Ylpön Katu 34 (33520 Tampere) P.O. Box 100, FI-33014 Tampere University, Finland; Department of Clinical Chemistry, Fimlab Laboratories, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland; Department of Cardiology, Heart Center, Tampere University Hospital, Elämänaukio 1, 33520, Tampere, Finland.
³ Department of Emergency Medicine, Kanta-Häme Central Hospital, Ahvenistontie 20, 13530, Hämeenlinna, Finland; Department of Clinical Physiology, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland.
⁴ Department of Pediatrics, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland.
⁵ Faculty of Information Technology and Communication Sciences, Tampere University, Korkeakoulunkatu 3 (33720 Tampere), P.O. Box 692, FI-33014 Tampere University, Finland.
⁶ Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 10 (20520 Turku), FI-20014 University of Turku, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10 (20520 Turku), FI-20014 University of Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Kiinamyllynkatu 10 (20520 Turku), FI-20014 University of Turku, Finland.
⁷ Finnish Cardiovascular Research Center - Tampere, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland; Department of Clinical Physiology, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland.
⁸ Finnish Cardiovascular Research Center - Tampere, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland; Faculty of Medicine and Health Technology, Arvo Ylpön Katu 34 (33520 Tampere) P.O. Box 100, FI-33014 Tampere University, Finland; Department of Clinical Chemistry, Fimlab Laboratories, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland.
⁹ Finnish Cardiovascular Research Center - Tampere, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014 Tampere University, Finland; Faculty of Medicine and Health Technology, Arvo Ylpön Katu 34 (33520 Tampere) P.O. Box 100, FI-33014 Tampere University, Finland; Vascular Centre, Tampere University Hospital, Elämänaukio 2 (33520 Tampere), P.O. Box 2000, Tampere, 33521, Finland. Electronic address: niku.oksala@tuni.fi.

PMID: 33503553
DOI: 10.1016/j.atherosclerosis.2021.01.006

Abstract

Background and aims: The aim of this study was to examine an association of individual and combined pulse waveform parameters derived from bioimpedance measurements, that is pulse waves from a distal impedance plethysmographic (IPG), a whole-body impedance cardiographic (ICG) and transformed distal impedance plethysmographic (tIPG) signals, with markers of subclinical atherosclerosis, i.e. carotid intima-media thickness (cIMT), brachial artery flow-mediated dilation (FMD) and carotid artery distensibility (Cdist). The level of the association was also compared for arterial pulse wave velocity (PWV) and cIMT, FMD, and Cdist.

Methods: IPG, ICG, tIPG signals were measured from 1741 Finnish adults aged 30-45 years. The association between pulse wave parameters and cIMT, FMD and Cdist was studied using bootstrapped stepwise Akaike's Information Criterion method resulting in selection of parameters other than PWV, i.e. parameters having stronger association with cIMT, FMD and Cdist than PWV, in the model. Then risk scores were calculated from the selected pulse wave parameters and their association between cIMT, FMD and Cdist was studied with multivariable linear regression analysis.

Results: The risk score was found to be the third strongest predictor of subclinical atherosclerosis as indicated by cIMT measurement, the second strongest predictor of FMD and the strongest predictor of Cdist. These findings show that several individual pulse wave parameters were associated more strongly with cIMT, FMD, and Cdist than PWV when adjusted with clinical risk factors.

Conclusions: Impedance based pulse waveform analysis provides a useful tool for assessing cardiovascular risk and estimating presence of structural changes in the vasculature.

Keywords: Bioimpedance measurement; Carotid artery distensibility; Flow-mediated dilation; Intima-media thickness; Pulse waveform analysis; Subclinical atherosclerosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Atherosclerosis* / diagnostic imaging
Carotid Intima-Media Thickness*
Finland
Humans
Plethysmography, Impedance
Pulse Wave Analysis
Risk Factors