Functional versus morphological assessment of vascular age in patients with coronary heart disease
Yurdadogan, Tino; Malsch, Carolin; Kotseva, Kornelia; Wood, David; Leyh, Rainer; Ertl, Georg; Karmann, Wolfgang; Müller-Scholden, Lara; Morbach, Caroline; Breunig, Margret; Wagner, Martin; Gelbrich, Götz; Bots, Michiel L.; Heuschmann, Peter U.; Störk, Stefan
(2021) Scientific Reports, volume 11, issue 1, pp. 1 - 10
(Article)
Abstract
Communicating cardiovascular risk based on individual vascular age (VA) is a well acknowledged concept in patient education and disease prevention. VA may be derived functionally, e.g. by measurement of pulse wave velocity (PWV), or morphologically, e.g. by assessment of carotid intima-media thickness (cIMT). The purpose of this study was to
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investigate whether both approaches produce similar results. Within the context of the German subset of the EUROASPIRE IV survey, 501 patients with coronary heart disease underwent (a) oscillometric PWV measurement at the aortic, carotid-femoral and brachial-ankle site (PWVao, PWVcf, PWVba) and derivation of the aortic augmentation index (AIao); (b) bilateral cIMT assessment by high-resolution ultrasound at three sites (common, bulb, internal). Respective VA was calculated using published equations. According to VA derived from PWV, most patients exhibited values below chronological age indicating a counterintuitive healthier-than-anticipated vascular status: for VAPWVao in 68% of patients; for VAAIao in 52% of patients. By contrast, VA derived from cIMT delivered opposite results: e.g. according to VAtotal-cIMT accelerated vascular aging in 75% of patients. To strengthen the concept of VA, further efforts are needed to better standardise the current approaches to estimate VA and, thereby, to improve comparability and clinical utility.
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Keywords: Aged, Aging/pathology, Blood Vessels/pathology, Carotid Intima-Media Thickness, Coronary Disease/pathology, Female, Humans, Linear Models, Male, Middle Aged, Pulse Wave Analysis, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
ISSN: 2045-2322
Publisher: Nature Publishing Group
Note: Funding Information: Open Access funding enabled and organized by Projekt DEAL. The EUROASPIRE IV survey was carried out under the auspices of the European Society of Cardiology, EURObservational Research Programme. The study was supported through unrestricted research grants to the European Society of Cardiology by Amgen, Astra-Zeneca, Bristol-Myers Squibb/Emea Sarl, Glaxo-Smith-Kline, Hoffman La Roche, Merck, Sharp & Dohme. Data collection for the German subset of the EUROASPIRE IV study was supported by the German Ministry of Education and Research (BMBF) within the Comprehensive Heart Failure Center Würzburg (BMBF 01EO1004 and 01EO1504). Tino Yurdadogan received a scholarship from the Graduate School of Life Sciences (GSLS) of the University of Würzburg from 04/2014 – 03/2015. Part of this analysis will be included in the doctoral thesis of TY. Funding Information: Georg Ertl has received grants and honoraria from Bayer, Vifor, Novartis, and Boehringer Ingelheim. Kornelia Kotseva reports personal fees from Amgen Europe (consultancy fee) and personal fees from AstraZeneca (advisory board), outside the submitted work. Caroline Morbach reports a research cooperation with the University of Würzburg and Tomtec Imaging Systems funded by a research grant from the Bavarian Ministry of Economic Affairs, Regional Development and Energy, Germany, speakers honorarium from Amgen and Tomtec, a travel grant from Orion Pharma and Alnylam, and participation in Advisory and Patient Eligibility Boards sponsored by AKCEA, Alnylam, and EBR Systems, outside the submitted work. Götz Gelbrich reports grants from the Bavarian Sate Ministry of Economic Affairs (automatic measurement in echocardiography project) and Deutsche Forschungsgemeinschaft (FIND-AF II trial), outside the submitted work. Peter Heuschmann reports grants from German Ministry of Research and Education, German Research Foundation, European Union, Federal Joint Committee (G-BA) within the Innovationfond, Charité–Universitätsmedizin Berlin, Berlin Chamber of Physicians, German Parkinson Society, University Hospital Würzburg, Robert Koch Institute, German Heart Foundation, University Göttingen (within FIND-AF randomised, supported by an unrestricted research grant to the University Göttingen from Boehringer-Ingelheim), University Hospital Heidelberg (within RASUNOA-prime, supported by an unrestricted research grant to the University Hospital Heidelberg from Bayer, BMS, Boehringer-Ingelheim, Daiichi Sankyo), grants from Charité–Universitätsmedizin Berlin (within Mondafis, supported by an unrestricted research grant to the Charité from Bayer), outside the submitted work. Stefan Störk reports grants from Bundesministerium für Bildung und Forschung, other from Boston Scientific, other from Bayer, grants and other from Novartis, other from Boehringer Ingelheim, other from Vifor Pharma, other from Philips, grants from European Union, grants from Deutsche Herzstiftung, outside the submitted work. The remaining authors declare that they have no competing interests. Publisher Copyright: © 2021, The Author(s).
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