Pulse Wave Velocity as a Measure of Arterial Stiffness in Patients with Abdominal Aortic Aneurysm: A Systematic Review and Meta-Analysis

Background and Objective: The relationship between pulse wave velocity (PWV) levels and abdominal aortic aneurysm (AAA) remains controversial. A meta-analysis was performed to establish whether vascular pulse wave velocity (PWV) as a measure of arterial stiffness is different in patients with abdominal aortic aneurysms and controls. Methods: Pubmed, Embase, Cochrane and China National Knowledge Infrastructure (CNKI) were used for the meta-analysis with articles up to January 1, 2021. To compare PWV levels between AAA patients and healthy controls, pooled weighted mean difference (WMD) and its 95% confidence interval (Cl) were calculated. Subgroup analysis and funnel plots are used to assess the quality of the combined results to ensure a normal distribution of data with minimal bias. Study quality for eligible studies was assessed using the Agency for Health Care Research and Quality (AHRQ) inventory tool. Results: Nine cross-sectional studies, which included 439 abdominal aortic aneurysm cases and 382 healthy subjects, met inclusion criteria and were eligible for meta-analysis. We found that PWV levels were significantly higher (WMD(95% Cl): 2.36(2.02,2.70)) in AAA patients than healthy controls. After subgroup analysis, it was found that age, sex, smoking and hypertension had significant effects on the PWV levels. The normal distribution of the Funnel plot analysis suggests a low risk for publication bias. Conclusion: PWV levels were elevated in patients with AAA compared to healthy controls, with PWV affected by age, sex, smoking and hypertension. Our study suggests that the incidence of AAA is related to increased arterial stiffness.