Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2021 Sep 13;11(1):18164.
doi: 10.1038/s41598-021-96998-x.

Functional versus morphological assessment of vascular age in patients with coronary heart disease

Tino Yurdadogan  1 , Carolin Malsch  2 , Kornelia Kotseva  3 , David Wood  4 , Rainer Leyh  5 , Georg Ertl  6   7 , Wolfgang Karmann  8 , Lara Müller-Scholden  6 , Caroline Morbach  6 , Margret Breunig  6 , Martin Wagner  6   2 , Götz Gelbrich  2 , Michiel L Bots  9 , Peter U Heuschmann  2 , Stefan Störk  6
Affiliations
Comparative Study

Functional versus morphological assessment of vascular age in patients with coronary heart disease

Tino Yurdadogan et al. Sci Rep. .

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 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.

PubMed Disclaimer

Conflict of interest statement

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.

Figures

Figure 1
Figure 1
Percentage distribution of VArCCA minus age (a)), VAlCCA minus age (b)), VAtotal-cIMT minus age (c)), VAPWVao minus age (d)), VAPWVba minus age (e)) and VAAIXao minus age (f)). Visualisation of accelerated vascular aging (i.e., vascular age exceeding chronological age) by the distribution of the difference of vascular and chronological age. A negative value represents vascular pre-aging. Since analyses were performed with “81 years” being the maximum VA of the cIMT examination, only patients aged < 61 years could possibly enter the group of individuals exhibiting pre-aging of > 20 years. In general, vascular age derived from PWA (first row) was similar or even smaller than patients´ age while VA derived from cIMT (second row) delivered opposite results. VA vascular age, PWVao aortic pulse wave velocity, PWVba branchial-ankle pulse wave velocity, AIao aortic augmentation index, rCCA right common carotid artery, lCCA left common carotid artery, total-cIMT total carotid intima-media thickness.
See this image and copyright information in PMC

References

    1. Oconnor AM, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst. Rev. 2009;3:Cd001431. - PubMed
    1. Rodondi N, et al. Framingham risk score and alternatives for prediction of coronary heart disease in older adults. PLoS ONE. 2012;7(3):e34287. doi: 10.1371/journal.pone.0034287. - DOI - PMC - PubMed
    1. Piepoli MF, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR) Eur. Heart J. 2016;37(29):2315–2381. doi: 10.1093/eurheartj/ehw106. - DOI - PMC - PubMed
    1. Dumitrescu A, Mosteoru S, Gaita L, Pleava R, Gaita D. Vascular age-a helpful tool in assessing cardiovascular risk. Atherosclerosis. 2016;252:e52. doi: 10.1016/j.atherosclerosis.2016.07.401. - DOI
    1. Soureti A, Hurling R, Murray P, van Mechelen W, Cobain M. Evaluation of a cardiovascular disease risk assessment tool for the promotion of healthier lifestyles. Eur. J. Cardiovasc. Prev. Rehabil. 2010;17(5):519–523. doi: 10.1097/HJR.0b013e328337ccd3. - DOI - PubMed

Publication types