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. 2023 Sep-Oct;37(5):2178-2187.
doi: 10.21873/invivo.13317.

Comparison of Functional and Morphological Estimates of Vascular Age

Martin Sigl  1   2 , Laura Winter  1   2 , Gerhard Schumacher  3 , Stefanie Christina Helmke  3 , Tetyana Shchetynska-Marinova  1   2 , Klaus Amendt  1   2 , Daniel Duerschmied  1   2 , Anna Lena Hohneck  4   2
Affiliations

Comparison of Functional and Morphological Estimates of Vascular Age

Martin Sigl et al. In Vivo. 2023 Sep-Oct.

Abstract

Background/aim: Vascular age (VA) is an emerging metric in preventive cardiovascular (CV) medicine. VA can be derived from morphological parameters such as carotid intima-media thickness (CIMT), or functional parameters such as pulse wave analysis (PWA), which celebrates its 100th birthday. This study aimed to investigate whether the results of both approaches are comparable.

Patients and methods: On the occasion of the double 100th anniversary of PWA and the Mannheim Clinic, 100 volunteers underwent a) bilateral CIMT assessment using high-resolution ultrasound and b) oscillometric PWA at the brachial forearm site. The respective VAs were calculated using previously published equations.

Results: Median age of the participants was 53.6 years (range=39.8-62.6 years), and 56% were female. Median CIMT was 632.5 μm (range=548.8-730.0 μm). Median PWA-derived VA was 55.3 years (36.5-70.5 years). Different values were obtained for CIMT-derived VA, depending on the reference cohort used as calculation basis, ranging from median 43.7 (26.2-59.5 years) to median 64.0 years (43.5-82.1 years). In 46% of the participants divergent VAs were found, that is, the calculated age was higher according to one method and lower according to the other. Correlation analysis revealed a strong dependence of VA (both PWA- and CIMT-derived) and chronological age, as well as an increase in CV risk factors and the detection of plaques with age.

Conclusion: Different approaches for estimating VA are not comparable and often produce contradictory results. The current methods and their validity must be critically assessed if they are not standardized.

Keywords: Vascular age; arterial stiffness; carotid ultrasound; intima-media thickness; pulse wave analysis.

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Conflict of interest statement

G. Schumacher is one of the founders and chief executive officers of inmediQ Gesellschaft mit beschränkter Haftung (Butzbach, Germany), which distributes the device (VascAssist) used in this study. All other Authors declare that they have no competing financial interests or personal relationships that could have influenced the work reported in this study.

Figures

Figure 1
Figure 1. Vascular ages. Comparison of median (IQR) vascular ages (VAs) and chronological age with one-factor analysis of variance and Fisher LSD post-hoc test. CIMT: Carotid intima-media thickness; gen.: general population; IQR: interquartile range; PWA: pulse wave analysis.
Figure 2
Figure 2. Parallel plot vascular ages. Parallel plot depicting the vascular age (VA) in comparison to the calendar age, divided into three groups [green: both pulse wave analysis (PWA)-derived VA and (mean) CIMTderived VA lower than calendar age, blue: both higher than calendar age, red: divergent values, i.e., VA was higher according to one method and lower according to the other]. CIMT: Carotid intima-media thickness.
Figure 3
Figure 3. Correlation matrix. Correlation matrix of vascular age(s) and cardiovascular risk factors with indications of Spearman’s rank correlations r. CIMT: Carotid intima-media thickness; CVRF: cardiovascular risk factor; gen. pop.: general population; PWA: pulse wave analysis; VA: vascular age.
See this image and copyright information in PMC

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