| Summary: | Introduction
Although pulse wave velocity (PWV), a proxy of arterial stiffness, is a strong predictor of cardiovascular complications, it is confounded by blood pressure (BP) and heart rate at the time of examination. Furthermore, establishing whether an artery is stiffened or not does not inform a clinician on the cause of the stiffening.
Quantification of PWV’s confounders
This talk will focus on BP as a confounder of PWV. We developed a method to patient-specifically determine the dependence of PWV on BP—on average 1 m/s per 10 mmHg diastolic BP—and used it to disentangle BP-dependent and -independent stiffening in hypertension and cancer patients. We furthermore showed that cardio-ankle vascular index (CAVI)—a measure that is often presented as BP-independent—shows a residual BP dependence that can be readily corrected using a modified equation (CAVI0). Both developed methods are directly applicable to clinical measurement data from individual patients.
Interpretation of changes in PWV
We developed a computer modelling procedure to disentangle contributions of the individual wall components—collagen, elastin, and smooth muscle—to arterial stiffening in patient data. We used this approach to show that with ageing, the biomechanical phenotype shifted from elastin-dominated to collagen-dominated load bearing.
Outlook
Model-based interpretation of arterial mechanics provides a promising tool to further improve understanding of arterial stiffening. In my future career, I will use such methodology to study stiffening in various mouse models. The results of these studies can potentially be used to further improve understanding and interpretation of arterial stiffening in patients.
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