A Novel Doppler Assessment of Vascular Aging: Integrating Aortic Stiffness and Cerebral Hemodynamics

Aortic stiffness is recognized as an independent predictor of cardiovascular events and a marker of early vascular aging. The gold standard assessment method, carotid-femoral pulse wave velocity (cfPWV), has significant limitations: the necessity of access to the groin area, the requirement for specialized equipment with an ECG channel, and operator dependency. This complicates its widespread use in clinical practice. As a solution, a novel method for assessing aortic pulse wave velocity based on carotid Doppler waveform analysis has been proposed. The technique is based on measuring the time interval between the onset of the early systolic wave and the reflected pulse wave during an ultrasound examination of the carotid arteries. A comparative study involving 157 patients demonstrated a high correlation between the new method and cfPWV (r = 0.758), while Bland–Altman analysis confirmed the potential interchangeability of the methods with a correction factor of 1.157. A key advantage of the approach is the possibility of simultaneously assessing cerebral artery stiffness and the degree of systolic load on them through analysis of the end-diastolic velocity and pulsatility index from the same Doppler waveforms. The method is integrated into a routine ultrasound examination of the brachiocephalic arteries, providing a comprehensive assessment of systemic and cerebral hemodynamics without increasing procedure time or requiring additional equipment, which opens prospects for large-scale vascular age screening.