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Central and peripheral pulse wave velocity and subclinical myocardial stress and damage in older adults.

TitleCentral and peripheral pulse wave velocity and subclinical myocardial stress and damage in older adults.
Publication TypeJournal Article
Year of Publication2019
AuthorsLiu S, Kim ED, Wu A, Meyer ML, Cheng S, Hoogeveen RC, Ballantyne CM, Tanaka H, Heiss G, Selvin E
Secondary AuthorsMatsushita K
JournalPLoS One
Volume14
Issue2
Paginatione0212892
Date Published2019
ISSN1932-6203
KeywordsAged, Aged, 80 and over, Biomarkers, Cardiovascular Diseases, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Natriuretic Peptide, Brain, Peptide Fragments, Pulse Wave Analysis, Risk Factors, Troponin T, Vascular Stiffness
Abstract

BACKGROUND: Arterial stiffness independently predicts cardiovascular disease. However, few studies have evaluated the associations of central and peripheral pulse wave velocity (PWV) with biomarkers of both myocardial stress (natriuretic peptide [NT-proBNP]) and damage (high-sensitivity cardiac troponin-T [hs-cTnT]) among persons without cardiac disease.

METHODS: We examined 3,348 participants (67-90 years) without prevalent cardiac disease in the Atherosclerosis Risk in Communities (ARIC) Study (2011-13). The cross-sectional associations of PWV quartiles for central arterial segments (carotid-femoral, heart-carotid, heart-femoral) and peripheral artery (femoral-ankle) with NT-proBNP and hs-cTnT were evaluated accounting for potential confounders.

RESULTS: Most PWV measures demonstrated J- or U-shaped associations with the two cardiac biomarkers. The highest (Q4) vs. second lowest (Q2) quartile of central PWV measures (carotid-femoral, heart-carotid, heart-femoral PWV) were associated with higher levels of NT-proBNP independently of demographic characteristics. The associations were less evident for hs-cTnT. These associations were attenuated after adjusting for traditional cardiovascular risk factors, but the heart-carotid PWV-NT-proBNP relationship remained borderline significant (difference in log-NT-proBNP = 0.08 [-0.01, 0.17] in Q4 vs. Q2, p = 0.07). Peripheral PWV demonstrated inverse associations. Higher values of NT-proBNP were seen in the lowest vs. second lowest quartile of all PWV measures.

CONCLUSIONS: Central stiffness measures showed stronger associations with cardiac biomarkers (particularly NT-proBNP) than peripheral measures among older adults without cardiac disease. Our findings are consistent with the concept of ventricular-vascular coupling and suggest that central rather than peripheral arterial hemodynamics are more closely related to myocardial stress rather than damage.

DOI10.1371/journal.pone.0212892
Alternate JournalPLoS One
PubMed ID30811490
PubMed Central IDPMC6392306
Grant ListK24 DK106414 / DK / NIDDK NIH HHS / United States
R01 AG053938 / AG / NIA NIH HHS / United States
R01 HL134320 / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States