Key result
Density score is independently linked to PWV, while hemorheologic parameters show no independent association.
Why the study?
Does blood density score independently affect pulse wave velocity in patients with coronary artery disease?
Observational (n=814)
Does blood density score independently affect pulse wave velocity in patients with coronary artery disease?
p-value: p=<0.001
Blood density score (hemoglobin plus total protein) is an independent determinant of pulse wave velocity, suggesting that the mechanical properties of blood influence vascular stiffness measurements.
Density score may influence PWV interpretation in CAD; leaves open whether blood mechanical properties causally affect arterial stiffness.
PWV, a surrogate marker for vascular stiffness, can be also expressed by the Bramwell-Hill equation. The effect of blood density to PWV has been ignored, because variation of blood density is assumed to be negligible. In some clinical situation, blood density could be changed, and blood density as a mechanical property of blood flow might affect to PWV. While the elastic property plays an important role in determining the wave propagation in an elastic tube, our assumption is that there might be some relation between blood flow and vascular wall, and that the characteristics of blood flow might influence PWV. This study was objected to investigate the role of mechanical and hemorheologic parameters on PWV in subjects with cardiovascular disease. We have measured and analyzed the PWV, hemorheologic parameters, and other clinical parameters in 814 patients with coronary arterial disease scheduled for coronary angiography. There is no commercial method for measuring whole blood density. So, we defined the density score, which is sum of hemoglobin and total protein. And the hemorheologic parameters were measured within 4 hours after sampling by automated microfluidic hemorheometer. And the effect of all the clinical and hemorheologic parameter on PWV was analyzed by multiple linear regression analysis. Many clinical parameters including age and blood pressure, high shear WBV and ESR as hemorheologic parameters, and density score were correlated well with ba-PWV. However, many clinical variables, high shear WBV and ESR lost the independent significance on multivariable regression analysis. Only age, SBP, and density score were independent variables (p < 0.001). In conclusion, density score as a mechanical property of blood might be suggested as an independent variable influencing PWV in addition to age and blood pressure, but hemorheologic parameters, such as RBC deformability, aggregation, and whole blood viscosity do not affect PWV independently.
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Kim et al. (2013) conducted an observational in Coronary arterial disease (n=814). Density score and hemorheologic parameters was evaluated on Pulse wave velocity (ba-PWV) (p=<0.001). Density score, age, and systolic blood pressure were independently associated with pulse wave velocity (p<0.001), whereas hemorheologic parameters did not affect PWV independently.
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