Vascular Aging Detected by Peripheral Endothelial Dysfunction Is Associated With ECG‐Derived Physiological Aging
Background An artificial intelligence algorithm that detects age using the 12‐lead ECG has been suggested to signal “physiologic age.” This study aimed to investigate the association of peripheral microvascular endothelial function (PMEF) as an index of vascular aging, with accelerated physiologic a...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.018656 |
| _version_ | 1819175036128329728 |
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| author | Takumi Toya Ali Ahmad Zachi Attia Michal Cohen‐Shelly Ilke Ozcan Peter A Noseworthy Francisco Lopez‐Jimenez Suraj Kapa Lilach O Lerman Paul A Friedman Amir Lerman |
| author_facet | Takumi Toya Ali Ahmad Zachi Attia Michal Cohen‐Shelly Ilke Ozcan Peter A Noseworthy Francisco Lopez‐Jimenez Suraj Kapa Lilach O Lerman Paul A Friedman Amir Lerman |
| author_sort | Takumi Toya |
| collection | DOAJ |
| description | Background An artificial intelligence algorithm that detects age using the 12‐lead ECG has been suggested to signal “physiologic age.” This study aimed to investigate the association of peripheral microvascular endothelial function (PMEF) as an index of vascular aging, with accelerated physiologic aging gauged by ECG‐derived artificial intelligence–estimated age. Methods and Results This study included 531 patients who underwent ECG and a noninvasive PMEF assessment using reactive hyperemia peripheral arterial tonometry. Abnormal PMEF was defined as reactive hyperemia peripheral arterial tonometry index ≤2.0. Accelerated or delayed physiologic aging was calculated by the Δ age (ECG‐derived artificial intelligence–estimated age minus chronological age), and the association between Δ age and PMEF as well as its impact on composite major adverse cardiovascular events were investigated. Δ age was higher in patients with abnormal PMEF than in patients with normal PMEF (2.3±7.8 versus 0.5±7.7 years; P=0.01). Reactive hyperemia peripheral arterial tonometry index was negatively associated with Δ age after adjustment for cardiovascular risk factors (standardized β coefficient, –0.08; P=0.048). The highest quartile of Δ age was associated with an increased risk of major adverse cardiovascular events compared with the first quartile of Δ age in patients with abnormal PMEF, even after adjustment for cardiovascular risk factors (hazard ratio, 4.72; 95% CI, 1.24–17.91; P=0.02). Conclusions Vascular aging detected by endothelial function is associated with accelerated physiologic aging, as assessed by the artificial intelligence–ECG Δ age. Patients with endothelial dysfunction and the highest quartile of accelerated physiologic aging have a marked increase in risk for cardiovascular events. |
| first_indexed | 2024-12-22T20:48:28Z |
| format | Article |
| id | doaj.art-7e16cb44b7194e859b7f533539cceb9e |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T20:48:28Z |
| publishDate | 2021-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-7e16cb44b7194e859b7f533539cceb9e2022-12-21T18:13:10ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-02-0110310.1161/JAHA.120.018656Vascular Aging Detected by Peripheral Endothelial Dysfunction Is Associated With ECG‐Derived Physiological AgingTakumi Toya0Ali AhmadZachi Attia1Michal Cohen‐Shelly2Ilke Ozcan3Peter A Noseworthy4Francisco Lopez‐Jimenez5Suraj Kapa6Lilach O Lerman7Paul A Friedman8Amir Lerman9Department of Cardiovascular Medicine Mayo Clinic Rochester MNDepartment of Cardiovascular Medicine Mayo Clinic Rochester MNDepartment of Cardiovascular Medicine Mayo Clinic Rochester MNDepartment of Cardiovascular Medicine Mayo Clinic Rochester MNDepartment of Cardiovascular Medicine Mayo Clinic Rochester MNDepartment of Cardiovascular Medicine Mayo Clinic Rochester MNDepartment of Cardiovascular Medicine Mayo Clinic Rochester MNDivision of Nephrology and Hypertension Mayo Clinic Rochester MNDepartment of Cardiovascular Medicine Mayo Clinic Rochester MNDepartment of Cardiovascular Medicine Mayo Clinic Rochester MNBackground An artificial intelligence algorithm that detects age using the 12‐lead ECG has been suggested to signal “physiologic age.” This study aimed to investigate the association of peripheral microvascular endothelial function (PMEF) as an index of vascular aging, with accelerated physiologic aging gauged by ECG‐derived artificial intelligence–estimated age. Methods and Results This study included 531 patients who underwent ECG and a noninvasive PMEF assessment using reactive hyperemia peripheral arterial tonometry. Abnormal PMEF was defined as reactive hyperemia peripheral arterial tonometry index ≤2.0. Accelerated or delayed physiologic aging was calculated by the Δ age (ECG‐derived artificial intelligence–estimated age minus chronological age), and the association between Δ age and PMEF as well as its impact on composite major adverse cardiovascular events were investigated. Δ age was higher in patients with abnormal PMEF than in patients with normal PMEF (2.3±7.8 versus 0.5±7.7 years; P=0.01). Reactive hyperemia peripheral arterial tonometry index was negatively associated with Δ age after adjustment for cardiovascular risk factors (standardized β coefficient, –0.08; P=0.048). The highest quartile of Δ age was associated with an increased risk of major adverse cardiovascular events compared with the first quartile of Δ age in patients with abnormal PMEF, even after adjustment for cardiovascular risk factors (hazard ratio, 4.72; 95% CI, 1.24–17.91; P=0.02). Conclusions Vascular aging detected by endothelial function is associated with accelerated physiologic aging, as assessed by the artificial intelligence–ECG Δ age. Patients with endothelial dysfunction and the highest quartile of accelerated physiologic aging have a marked increase in risk for cardiovascular events.https://www.ahajournals.org/doi/10.1161/JAHA.120.018656artificial intelligenceperipheral microvascular endothelial dysfunctionphysiological agereactive hyperemia peripheral arterial tonometry indexvascular age |
| spellingShingle | Takumi Toya Ali Ahmad Zachi Attia Michal Cohen‐Shelly Ilke Ozcan Peter A Noseworthy Francisco Lopez‐Jimenez Suraj Kapa Lilach O Lerman Paul A Friedman Amir Lerman Vascular Aging Detected by Peripheral Endothelial Dysfunction Is Associated With ECG‐Derived Physiological Aging Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease artificial intelligence peripheral microvascular endothelial dysfunction physiological age reactive hyperemia peripheral arterial tonometry index vascular age |
| title | Vascular Aging Detected by Peripheral Endothelial Dysfunction Is Associated With ECG‐Derived Physiological Aging |
| title_full | Vascular Aging Detected by Peripheral Endothelial Dysfunction Is Associated With ECG‐Derived Physiological Aging |
| title_fullStr | Vascular Aging Detected by Peripheral Endothelial Dysfunction Is Associated With ECG‐Derived Physiological Aging |
| title_full_unstemmed | Vascular Aging Detected by Peripheral Endothelial Dysfunction Is Associated With ECG‐Derived Physiological Aging |
| title_short | Vascular Aging Detected by Peripheral Endothelial Dysfunction Is Associated With ECG‐Derived Physiological Aging |
| title_sort | vascular aging detected by peripheral endothelial dysfunction is associated with ecg derived physiological aging |
| topic | artificial intelligence peripheral microvascular endothelial dysfunction physiological age reactive hyperemia peripheral arterial tonometry index vascular age |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.018656 |
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