Key result
Proximal aortic stiffening tracks with pressure-time indices but is not linked to SEVR changes.
Why the study?
Central arterial stiffening may impair myocardial oxygen supply-demand balance, and it was uncertain whether longitudinal changes in proximal aortic stiffness are more closely associated with changes in subendocardial viability ratio and its constituent pressure-time indices than changes in overall aortic stiffness.
Cohort (n=64)
Longitudinal changes in proximal aortic stiffness over 10 years in healthy adults are associated with changes in individual systolic and diastolic pressure-time indices of myocardial oxygen demand and supply, but not with their overall balance as assessed by the subendocardial viability ratio.
Answers are grounded in this paper and cite their sources.
Heart-brachial pulse wave velocity should not be used as a surrogate for subendocardial perfusion; leaves open which non-invasive arterial stiffness metrics reliably track myocardial supply-demand balance.
Central arterial stiffening may increase systolic aortic impedance and reduce diastolic perfusion pressure, thereby impairing myocardial oxygen supply-demand balance. We tested the hypothesis that longitudinal changes in proximal aortic stiffness are more closely associated with changes in subendocardial viability ratio (SEVR) and its constituent systolic and diastolic pressure-time indices than changes in overall aortic stiffness. We investigated 10-year longitudinal changes in central arterial stiffness in 64 adults spanning a wide age range (19-73 years at pre-measurement). Carotid-femoral pulse wave velocity (cfPWV) was measured as the reference standard for aortic stiffness, whereas heart-brachial PWV (hbPWV) was used as an index of aortic stiffness for more proximal segment. Aortic pressure waveform was derived from carotid arterial pressure, and SEVR was calculated as the ratio of diastolic to systolic aortic pressure-time integrals. cfPWV and hbPWV increased, whereas SEVR decreased over the follow-up period in all age groups (p<0.01). Although changes in hbPWV were positively associated with changes in both systolic and diastolic pressure-time indices (r=0.41 and r=0.55, respectively; both p<0.01), they were not associated with changes in SEVR (r=0.02, p=0.87). Changes in cfPWV were not significantly associated with changes in either pressure-time index or SEVR. These results suggest that longitudinal changes in proximal aortic stiffness are associated with changes in the individual pressure-time indices of myocardial oxygen demand and supply, but not with changes in their balance as assessed by SEVR.
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Sakamoto et al. (2026) conducted a cohort in Central arterial stiffening in healthy adults (n=64). Proximal aortic stiffness (heart-brachial pulse wave velocity, hbPWV) vs. Overall aortic stiffness (carotid-femoral pulse wave velocity, cfPWV) was evaluated on Changes in subendocardial viability ratio (SEVR) and systolic/diastolic pressure-time indices (r=0.02 (SEVR); r=0.41 (systolic); r=0.55 (diastolic), p=0.87 (SEVR); <0.01 (systolic and diastolic)). Changes in proximal aortic stiffness (hbPWV) correlated with systolic (r=0.41) and diastolic (r=0.55; both p<0.01) pressure-time indices, but not with SEVR (r=0.02, p=0.87).
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