Key result
Impedance-based pulse waveform scores outperform pulse wave velocity in predicting subclinical atherosclerosis markers.
Why the study?
To examine the association of bioimpedance-derived pulse waveform parameters (IPG, ICG, and tIPG) with markers of subclinical atherosclerosis (cIMT, FMD, and Cdist) and compare them with arterial PWV.
Do pulse waveform parameters derived from bioimpedance measurements predict markers of subclinical atherosclerosis better than pulse wave velocity in adults?
Cross-Sectional (n=1,741)
Do pulse waveform parameters derived from bioimpedance measurements predict markers of subclinical atherosclerosis better than pulse wave velocity in adults?
Impedance-based pulse waveform analysis provides a useful tool for assessing cardiovascular risk and structural vascular changes, demonstrating stronger associations with markers of subclinical atherosclerosis than traditional pulse wave velocity.
Answers are grounded in this paper and cite their sources.
Impedance-based scores merit prospective outcome validation; leaves open superiority over PWV for clinical risk stratification.
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.
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Haapala et al. (2021) conducted a cross-sectional in Subclinical atherosclerosis (n=1,741). Impedance plethysmography-based pulse waveform analysis vs. Pulse wave velocity (PWV) was evaluated on Association with markers of subclinical atherosclerosis (cIMT, FMD, and Cdist). Impedance-based pulse waveform risk scores were stronger predictors of subclinical atherosclerosis markers (cIMT, FMD, and Cdist) than pulse wave velocity when adjusted for clinical risk factors.
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