(Hypertension. 1996;27:168-175.)
© 1996 American Heart Association, Inc.
Articles |
Validation of Carotid Artery Tonometry as a Means of Estimating Augmentation Index of Ascending Aortic Pressure
From the Division of Cardiology, Departments of Medicine, Veterans General Hospital–Taipei (C.-H.C., S.-P.W., M.-S.C.), the National Yang Ming University (C.-H.C., S.-P.W., M.-S.C., C.-T.T.) and Veterans General Hospital–Taichung (C.-T.T.), Republic of China; and the Division of Cardiology, Johns Hopkins Hospital, Baltimore, Md (A.N., E.N., D.A.K., P.P., F.C.P.Y.).
Abstract Our objective was to validate a carotid artery tonometry–derived augmentation index as a means to estimate augmentation index (AI) of ascending aortic pressure under various physiological conditions. A total of 66 patients (50 men, 16 women; mean age, 55 years; range, 21 to 78 years; 44 in Taiwan and 22 in the Unites States) undergoing diagnostic catheterization were studied. Arterial pressure contours were obtained simultaneously from the right common carotid artery by applanation tonometry with an external micromanometer-tipped probe and from the ascending aorta by a micromanometer-tipped catheter at baseline (n=62), after handgrip (n=36), or after sublingual nitroglycerin administration (n=17). The AI (expressed as percentage values) was calculated as the ratio of amplitude of the pressure wave above its systolic shoulder to the total pulse pressure. The carotid AI was consistently lower than the aortic AI, but the two were highly correlated at baseline and after both handgrip and nitroglycerin. Mean±SD and correlation coefficients were baseline (14±16, 28+±17, .77), handgrip (18±19, 32+±15, .86), and nitroglycerin (7±12, 18+±13, .52). In addition, after adjusting for age, sex, height, blood pressure, heart rate, and study site, the changes of both AIs from baseline values with handgrip or nitroglycerin were highly associated such that the aortic AI could be approximated from the carotid AI with appropriate regression equations. The high correlations and predictable changes after interventions between the central AI and those estimated from noninvasive carotid tonometry suggest that this technique may have wide applicability for many cardiovascular studies.
Key Words: tonometry • pulse wave • arteries • augmentation index
This article has been cited by other articles:
 |
|
 |
|
  C. Manisty, J. Mayet, R. J. Tapp, P. S. Sever, N. Poulter, S. A. McG. Thom, A. D. Hughes, and on behalf of the ASCOT Investigators Atorvastatin Treatment Is Associated With Less Augmentation of the Carotid Pressure Waveform in Hypertension: A Substudy of the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT) Hypertension, November 1, 2009; 54(5): 1009 - 1013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. H. Manisty, A. Zambanini, K. H. Parker, J. E. Davies, D. P. Francis, J. Mayet, S. A. McG Thom, A. D. Hughes, and on behalf of the Anglo-Scandinavian Cardiac Outcom Differences in the Magnitude of Wave Reflection Account for Differential Effects of Amlodipine- Versus Atenolol-Based Regimens on Central Blood Pressure: An Anglo-Scandinavian Cardiac Outcome Trial Substudy Hypertension, October 1, 2009; 54(4): 724 - 730. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. P Schneider, C. Delles, A. U Klingbeil, M. Ludwig, R. E Kolloch, M. Krekler, K. O Stumpe, and R. E Schmieder Effect of angiotensin receptor blockade on central haemodynamics in essential hypertension: results of a randomised trial Journal of Renin-Angiotensin-Aldosterone System, March 1, 2008; 9(1): 49 - 56. [Abstract] [PDF]
|
|
|
|
 |
|
 M. Shimizu and K. Kario Review: Role of the augmentation index in hypertension Therapeutic Advances in Cardiovascular Disease, February 1, 2008; 2(1): 25 - 35. [Abstract] [PDF]
|
|
|
|
|
|
S. M. Farasat, C. H. Morrell, A. Scuteri, C.-T. Ting, F. C.P. Yin, H. A. Spurgeon, C.-H. Chen, E. G. Lakatta, and S. S. Najjar Pulse Pressure Is Inversely Related to Aortic Root Diameter Implications for the Pathogenesis of Systolic Hypertension Hypertension, February 1, 2008; 51(2): 196 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. A. Borlaug, V. Melenovsky, M. M. Redfield, K. Kessler, H.-J. Chang, T. P. Abraham, and D. A. Kass Impact of Arterial Load and Loading Sequence on Left Ventricular Tissue Velocities in Humans J. Am. Coll. Cardiol., October 16, 2007; 50(16): 1570 - 1577. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Pieretti, M. J. Roman, R. B. Devereux, M. D. Lockshin, M. K. Crow, S. A. Paget, J. E. Schwartz, L. Sammaritano, D. M. Levine, and J. E. Salmon Systemic Lupus Erythematosus Predicts Increased Left Ventricular Mass Circulation, July 24, 2007; 116(4): 419 - 426. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Roman, R. B. Devereux, J. R. Kizer, E. T. Lee, J. M. Galloway, T. Ali, J. G. Umans, and B. V. Howard Central Pressure More Strongly Relates to Vascular Disease and Outcome Than Does Brachial Pressure: The Strong Heart Study Hypertension, July 1, 2007; 50(1): 197 - 203. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-M. Tartiere, D. Logeart, F. Beauvais, C. Chavelas, L. Kesri, J.-Y. Tabet, and A. Cohen-solal Non-invasive radial pulse wave assessment for the evaluation of left ventricular systolic performance in heart failure Eur J Heart Fail, May 1, 2007; 9(5): 477 - 483. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. J. Kullo and A. R. Malik Arterial Ultrasonography and Tonometry as Adjuncts to Cardiovascular Risk Stratification J. Am. Coll. Cardiol., April 3, 2007; 49(13): 1413 - 1426. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Melenovsky, B. A. Borlaug, B. Rosen, I. Hay, L. Ferruci, C. H. Morell, E. G. Lakatta, S. S. Najjar, and D. A. Kass Cardiovascular Features of Heart Failure With Preserved Ejection Fraction Versus Nonfailing Hypertensive Left Ventricular Hypertrophy in the Urban Baltimore Community: The Role of Atrial Remodeling/Dysfunction J. Am. Coll. Cardiol., January 16, 2007; 49(2): 198 - 207. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Laurent, J. Cockcroft, L. Van Bortel, P. Boutouyrie, C. Giannattasio, D. Hayoz, B. Pannier, C. Vlachopoulos, I. Wilkinson, H. Struijker-Boudier, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications Eur. Heart J., November 1, 2006; 27(21): 2588 - 2605. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Hirata, T. Yaginuma, M. F. O'Rourke, and M. Kawakami Age-Related Changes in Carotid Artery Flow and Pressure Pulses: Possible Implications for Cerebral Microvascular Disease Stroke, October 1, 2006; 37(10): 2552 - 2556. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. McEniery, Yasmin, I. R. Hall, A. Qasem, I. B. Wilkinson, J. R. Cockcroft, and on behalf of the ACCT Investigators Normal Vascular Aging: Differential Effects on Wave Reflection and Aortic Pulse Wave Velocity: The Anglo-Cardiff Collaborative Trial (ACCT) J. Am. Coll. Cardiol., November 1, 2005; 46(9): 1753 - 1760. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Williams, B. A Kingwell, K. Burke, J. McPherson, and A. M Dart Folic acid supplementation for 3 wk reduces pulse pressure and large artery stiffness independent of MTHFR genotype Am. J. Clinical Nutrition, July 1, 2005; 82(1): 26 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. D. Steinback, D. D. O'Leary, J. Bakker, A. D. Cechetto, H. M. Ladak, and J. K. Shoemaker Carotid distensibility, baroreflex sensitivity, and orthostatic stress J Appl Physiol, July 1, 2005; 99(1): 64 - 70. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Roman, R. B. Devereux, J. E. Schwartz, M. D. Lockshin, S. A. Paget, A. Davis, M. K. Crow, L. Sammaritano, D. M. Levine, B.-A. Shankar, et al. Arterial Stiffness in Chronic Inflammatory Diseases Hypertension, July 1, 2005; 46(1): 194 - 199. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Verbeke, P. Segers, S. Heireman, R. Vanholder, P. Verdonck, and L. M. Van Bortel Noninvasive Assessment of Local Pulse Pressure: Importance of Brachial-to-Radial Pressure Amplification Hypertension, July 1, 2005; 46(1): 244 - 248. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. McEniery, Yasmin, S. Wallace, K. Maki-Petaja, B. McDonnell, J. E. Sharman, C. Retallick, S. S. Franklin, M. J. Brown, R. C. Lloyd, et al. Increased Stroke Volume and Aortic Stiffness Contribute to Isolated Systolic Hypertension in Young Adults Hypertension, July 1, 2005; 46(1): 221 - 226. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X. Zhong, H. J. Hilton, G. J. Gates, S. Jelic, Y. Stern, M. N. Bartels, R. E. DeMeersman, and R. C. Basner Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation J Appl Physiol, June 1, 2005; 98(6): 2024 - 2032. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Senzaki, C.-H. Chen, H. Ishido, S. Masutani, T. Matsunaga, M. Taketazu, T. Kobayashi, N. Sasaki, S. Kyo, and Y. Yokote Arterial Hemodynamics in Patients After Kawasaki Disease Circulation, April 26, 2005; 111(16): 2119 - 2125. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. de Simone, M. J. Roman, M. H. Alderman, M. Galderisi, O. de Divitiis, and R. B. Devereux Is High Pulse Pressure a Marker of Preclinical Cardiovascular Disease? Hypertension, April 1, 2005; 45(4): 575 - 579. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. O'Rourke and W. W. Nichols Aortic Diameter, Aortic Stiffness, and Wave Reflection Increase With Age and Isolated Systolic Hypertension Hypertension, April 1, 2005; 45(4): 652 - 658. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Segers, D. Georgakopoulos, M. Afanasyeva, H. C. Champion, D. P. Judge, H. D. Millar, P. Verdonck, D. A. Kass, N. Stergiopulos, and N. Westerhof Conductance catheter-based assessment of arterial input impedance, arterial function, and ventricular-vascular interaction in mice Am J Physiol Heart Circ Physiol, March 1, 2005; 288(3): H1157 - H1164. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. J. Meijboom, B. E. Westerhof, G. J. Nollen, J. A.E. Spaan, B. A.J.M. de Mol, M. J.H.M. Jacobs, and B. J.M. Mulder Beta-blocking therapy in patients with the Marfan syndrome and entire aortic replacement Eur. J. Cardiothorac. Surg., November 1, 2004; 26(5): 901 - 906. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Yasmin, C. M. McEniery, S. Wallace, I. S. Mackenzie, J. R. Cockcroft, and I. B. Wilkinson C-Reactive Protein Is Associated With Arterial Stiffness in Apparently Healthy Individuals Arterioscler Thromb Vasc Biol, May 1, 2004; 24(5): 969 - 974. [Abstract] [Full Text]
|
|
|
|
 |
|
 A. A. Ahimastos, M. Formosa, A. M. Dart, and B. A. Kingwell Gender Differences in Large Artery Stiffness Pre- and Post Puberty J. Clin. Endocrinol. Metab., November 1, 2003; 88(11): 5375 - 5380. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Studinger, Z. Lenard, Z. Kovats, L. Kocsis, and M. Kollai Static and dynamic changes in carotid artery diameter in humans during and after strenuous exercise J. Physiol., July 15, 2003; 550(2): 575 - 583. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. L. Medley, B. A. Kingwell, C. D. Gatzka, P. Pillay, and T. J. Cole Matrix Metalloproteinase-3 Genotype Contributes to Age-Related Aortic Stiffening Through Modulation of Gene and Protein Expression Circ. Res., June 13, 2003; 92(11): 1254 - 1261. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Meune, I. Mahe, J.-J. Mourad, A. Cohen-Solal, B. Levy, J.-P. Kevorkian, G. Jondeau, A. Habib, M. Lebret, A.-L. Knellwolf, et al. Aspirin alters arterial function in patients with chronic heart failure treated with ACE inhibitors: a dose-mediated deleterious effect Eur J Heart Fail, June 1, 2003; 5(3): 271 - 279. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. J.L. Vuurmans, P. Boer, and H. A. Koomans Effects of Endothelin-1 and Endothelin-1 Receptor Blockade on Cardiac Output, Aortic Pressure, and Pulse Wave Velocity in Humans Hypertension, June 1, 2003; 41(6): 1253 - 1258. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Millasseau, S. J. Patel, S. R. Redwood, J. M. Ritter, and P. J. Chowienczyk Pressure Wave Reflection Assessed From the Peripheral Pulse: Is a Transfer Function Necessary? Hypertension, May 1, 2003; 41(5): 1016 - 1020. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Hope, D. B. Tay, I. T. Meredith, and J. D. Cameron Comparison of generalized and gender-specific transfer functions for the derivation of aortic waveforms Am J Physiol Heart Circ Physiol, September 1, 2002; 283(3): H1150 - H1156. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. S. Hayward, M. Kraidly, C. M. Webb, and P. Collins Assessment of endothelial function using peripheral waveform analysis: A clinical application J. Am. Coll. Cardiol., August 7, 2002; 40(3): 521 - 528. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Tycho Vuurmans, W. H. Boer, W.-J. W. Bos, P. J. Blankestijn, and H. A. Koomans Contribution of Volume Overload and Angiotensin II to the Increased Pulse Wave Velocity of Hemodialysis Patients J. Am. Soc. Nephrol., January 1, 2002; 13(1): 177 - 183. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. B. Wilkinson, S. S. Franklin, I. R. Hall, S. Tyrrell, and J. R. Cockcroft Pressure Amplification Explains Why Pulse Pressure Is Unrelated to Risk in Young Subjects Hypertension, December 1, 2001; 38(6): 1461 - 1466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. K. Waddell, A. M. Dart, T. L. Medley, J. D. Cameron, and B. A. Kingwell Carotid Pressure Is a Better Predictor of Coronary Artery Disease Severity Than Brachial Pressure Hypertension, October 1, 2001; 38(4): 927 - 931. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E.-R. Rietzschel, E. Boeykens, M. L. De Buyzere, D. A. Duprez, and D. L. Clement A Comparison Between Systolic and Diastolic Pulse Contour Analysis in the Evaluation of Arterial Stiffness Hypertension, June 1, 2001; 37 (6): e15 - e22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. D. Lehmann Citation of "Validation" References for Sphygmocor-Based Estimates of Central Aortic Blood Pressure J. Clin. Endocrinol. Metab., April 1, 2001; 86(4): 1844a - 1845. [Full Text]
|
|
|
|
|
|
A. M. Dart and B. A. Kingwell Pulse pressure--a review of mechanisms and clinical relevance J. Am. Coll. Cardiol., March 15, 2001; 37(4): 975 - 984. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Elsheikh, R. Bird, B. Casadei, G. S. Conway, and J. A. H. Wass The Effect of Hormone Replacement Therapy on Cardiovascular Hemodynamics in Women with Turner's Syndrome J. Clin. Endocrinol. Metab., February 1, 2000; 85(2): 614 - 618. [Abstract] [Full Text]
|
|
|
|
|
|
H. Snieder, C. S. Hayward, U. Perks, R. P. Kelly, P. J. Kelly, and T. D. Spector Heritability of Central Systolic Pressure Augmentation : A Twin Study Hypertension, February 1, 2000; 35(2): 574 - 579. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Yasmin and M.J. Brown Similarities and differences between augmentation index and pulse wave velocity in the assessment of arterial stiffness QJM, October 1, 1999; 92(10): 595 - 600. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Bertovic, T. K. Waddell, C. D. Gatzka, J. D. Cameron, A. M. Dart, and B. A. Kingwell Muscular Strength Training Is Associated With Low Arterial Compliance and High Pulse Pressure Hypertension, June 1, 1999; 33(6): 1385 - 1391. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.-H. Chen, M. Nakayama, M. Talbot, E. Nevo, B. Fetics, G. Gerstenblith, L. C. Becker, and D. A. Kass Verapamil acutely reduces ventricular-vascular stiffening and improves aerobic exercise performance in elderly individuals J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1602 - 1609. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. de Simone, M. J. Roman, M. J. Koren, G. A. Mensah, A. Ganau, and R. B. Devereux Stroke Volume/Pulse Pressure Ratio and Cardiovascular Risk in Arterial Hypertension Hypertension, March 1, 1999; 33(3): 800 - 805. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Cameron, B. P. McGrath, and A. M. Dart Use of radial artery applanation tonometry and a generalized transfer function to determine aortic pressure augmentation in subjects with treated hypertension J. Am. Coll. Cardiol., November 1, 1998; 32(5): 1214 - 1220. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. B. Lafleche, B. M. Pannier, B. Laloux, and M. E. Safar Arterial response during cold pressor test in borderline hypertension Am J Physiol Heart Circ Physiol, August 1, 1998; 275(2): H409 - H415. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Stergiopulos, B. E. Westerhof, and N. Westerhof Physical basis of pressure transfer from periphery to aorta: a model-based study Am J Physiol Heart Circ Physiol, April 1, 1998; 274(4): H1386 - H1392. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.-H. Chen, E. Nevo, B. Fetics, P. H. Pak, F. C.P. Yin, W. L. Maughan, and D. A. Kass Estimation of Central Aortic Pressure Waveform by Mathematical Transformation of Radial Tonometry Pressure : Validation of Generalized Transfer Function Circulation, April 1, 1997; 95(7): 1827 - 1836. [Abstract] [Full Text]
|
|
|
|
|
|
H. Senzaki, C.-H. Chen, and D. A. Kass Single-Beat Estimation of End-Systolic Pressure-Volume Relation in Humans: A New Method With the Potential for Noninvasive Application Circulation, November 15, 1996; 94(10): 2497 - 2506. [Abstract] [Full Text]
|
|
|
|
|
|
T. L. Medley, T. J. Cole, C. D. Gatzka, W. Y.S. Wang, A. M. Dart, and B. A. Kingwell Fibrillin-1 Genotype Is Associated With Aortic Stiffness and Disease Severity in Patients With Coronary Artery Disease Circulation, February 19, 2002; 105(7): 810 - 815. [Abstract] [Full Text] [PDF]
|
|