Pulse wave velocity values depend on both the algorithm used for detecting the so-called ‘foot of the wave’ at the measurement sites and path length measurement. An overview of the different techniques was recently published,20 and the list of techniques and devices applied in the different centres is provided in Appendix. We had to standardize the calculation of PWV.
Transit times are assessed as the time difference between two characteristic points on carotid and femoral waveforms. The characteristic points chosen are dependent on the type of waveform (flow, pressure, or diameter distension) and the algorithm used for its detection. The two most popular algorithms are (i) the intersecting tangent algorithm (Sphygmocor® system and for manual identification) and (ii) the point of maximal upstroke during systole (as used in the Complior® system). Different algorithms applied on the same waveforms can lead to differences in measured PWV values of 5–15%.13 (link) Since the point of maximal upstroke has been shown to underestimate PWV, especially when the rise time of the waveform is low,13 (link) we chose to standardize transit time on the intersecting tangent algorithm. To convert maximal upstroke transit times into the intersecting tangent algorithm, we used the relationship previously found by Millasseau et al.:13 (link)
Pulse wave velocity values are also markedly dependent on the carotid–femoral pathway measurement. This pathway can either be the direct distance measured between the carotid and femoral measurement sites, or the distance obtained by subtracting the carotid measurement site to sternal notch distance from the sternal notch to femoral measurement site distance. Differences in path length alone can lead to differences in PWV values of up to 30%.21 (link),22 (link) Equations to convert between these path length definitions with good precision were recently published:23 (link)
Because participating centres used different methods to measure PWV (see Table A1), path length values had to be standardized. The bulk of the data in the reference value database consists of PWV calculated using the direct path length. Subtracted path lengths were therefore standardized into direct path lengths using Eq. (2). However, as the use of direct distance (i.e. measured over the body surface) leads to overestimation of real PWV [using magnetic resonance imaging (MRI) or invasive measurements], we used a scaling factor of 0.8 derived from Sugawara et al.24 (link) and Weber et al.15 (link) to convert PWV obtained using direct distances to ‘real’ PWV.
In what follows, PWV is calculated using the intersecting tangent algorithm and the direct carotid to femoral path length, and then rescaled to real PWV using Eq. (4). Tables using PWV values based on the intersecting tangent algorithm and direct or subtracted distances are supplied asSupplementary material online .
Transit times are assessed as the time difference between two characteristic points on carotid and femoral waveforms. The characteristic points chosen are dependent on the type of waveform (flow, pressure, or diameter distension) and the algorithm used for its detection. The two most popular algorithms are (i) the intersecting tangent algorithm (Sphygmocor® system and for manual identification) and (ii) the point of maximal upstroke during systole (as used in the Complior® system). Different algorithms applied on the same waveforms can lead to differences in measured PWV values of 5–15%.13 (link) Since the point of maximal upstroke has been shown to underestimate PWV, especially when the rise time of the waveform is low,13 (link) we chose to standardize transit time on the intersecting tangent algorithm. To convert maximal upstroke transit times into the intersecting tangent algorithm, we used the relationship previously found by Millasseau et al.:13 (link)
Pulse wave velocity values are also markedly dependent on the carotid–femoral pathway measurement. This pathway can either be the direct distance measured between the carotid and femoral measurement sites, or the distance obtained by subtracting the carotid measurement site to sternal notch distance from the sternal notch to femoral measurement site distance. Differences in path length alone can lead to differences in PWV values of up to 30%.21 (link),22 (link) Equations to convert between these path length definitions with good precision were recently published:23 (link)
Because participating centres used different methods to measure PWV (see Table A1), path length values had to be standardized. The bulk of the data in the reference value database consists of PWV calculated using the direct path length. Subtracted path lengths were therefore standardized into direct path lengths using Eq. (2). However, as the use of direct distance (i.e. measured over the body surface) leads to overestimation of real PWV [using magnetic resonance imaging (MRI) or invasive measurements], we used a scaling factor of 0.8 derived from Sugawara et al.24 (link) and Weber et al.15 (link) to convert PWV obtained using direct distances to ‘real’ PWV.
In what follows, PWV is calculated using the intersecting tangent algorithm and the direct carotid to femoral path length, and then rescaled to real PWV using Eq. (4). Tables using PWV values based on the intersecting tangent algorithm and direct or subtracted distances are supplied as