Angiology: Open Access
Open Access

Abstract

Reproducibility and Impact of CT-Scanning on Pulse Wave Velocity Measurement for Cardiovascular Risk Stratification in an Asymptomatic Population

Thijs L Braber, Niek HJ Prakken, Arend Mosterd and Birgitta K Velthuis

Objective: Pulse wave velocity (PWV) measurements for aortic arterial stiffness and coronary CT angiography (CCTA) may help improve cardiovascular risk assessment in asymptomatic people. On the CT-table PWV measurement is an efficient addition to the CT workflow. This study evaluated if on CT-table PWV measurements are influenced by CT anticipation stress and if the PWV measurements are reproducible.

Methods: Aortic PWV measurement reproducibility was assessed in 41 asymptomatic male sportsmen (aged 56.5 ± 6.7 years) who underwent CCTA as part of a sports medical evaluation. Three consecutive measurements were performed, two outside the CT-room for intra-observer variability followed by one on the CT-table. Pearson correlation coefficients were assessed for agreement between measurements outside the CT-room and on the CT-table. Bland-Altman analysis of limits of agreement was assessed to evaluate intra-observer variability outside the CT-room.

Results: Aortic PWV and systolic blood pressure (SBP) on the CT-table were significantly higher (+0.61 m/s, P = 0.004 and + 7 mmHg, P = 0.003 respectively), with acceptable correlation (Pearson’s correlation 0.8, R² 0.6). The Pearson’s correlation coefficients of PWV measurements outside the CT-room showed good intra-observer agreement, (Pearson’s correlation 0.9, R² 0.8) The mean re-test difference and the 95% limits of agreement outside the CT-room were fair: 0.25 m/s, 95%CI -0.99–1.51 m/s.

Conclusion: On the CT-table PWV measurements, although higher due to anticipation stress causing higher SBP, are comparable to off-table measurements at rest. The reproducibility of PWV measurements is good when done prior to a coronary CT-scan and the limits of agreement are acceptable.