J Korean Surg Soc JKSS Journal of the Korean Surgical Society 1226-0053 2093-0488 The Korean Surgical Society 10.4174/jkss.2010.79.6.481 Original Article Comparison of the Risk Factors for Arterial Stiffness between Extremity Muscular and Abdominal Elastic Arteries Park Jong Kwon M.D. Kim Kwan Woo M.D. Park Jeong-Ik M.D. Oh Sung Jin M.D. Suh Byoung Jo M.D. Oh Sang Hoon M.D. Jun Si-Youl M.D. 1 Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea. Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea. Corresponding author (jongkwon.park@gmail.com) 12 2010 31 12 2010 79 6 481 485 12 05 2010 19 08 2010 Copyright © 2010 The Korean Surgical Society 2010 Purpose

Muscular artery differs from elastic artery in physical properties and constituents of the arterial wall. To investigate the difference between muscular and elastic arteries, we measured the pulse wave velocities (PWVs) in lower extremity muscular arteries (femoral ankle PWV, faPWV) and abdominal elastic arteries (brachial femoral PWV, bfPWV), and searched for the relationships between the PWVs of muscular, elastic arteries and the risk factors of arteriosclerosis.

 Methods

184 normal volunteers were enrolled in the study. Among them, the ratios of male/female, smoker/non-smoker, and hypertension/normal were 81/103, 66/118, and 63/121, respectively. Using volume plethysmography, faPWV and bfPWV were measured. The risk factors of arteriosclerosis in this study were age, gender, smoking, hypertension, body mass index, low density lipoprotein, high density lipoprotein, triglyceride, hemoglobin A1C, and white blood cell.

 Results

The PWVs of lower extremity muscular arteries (faPWVs) were significantly faster than those of abdominal elastic arteries (bfPWVs) (right, P<0.001; left, P<0.001) Multiple regression analysis revealed that the independent risk factors of the PWV were age (right, P<0.001; left, P<0.001) and gender (right, P=0.008; left, p=0.014) in abdominal elastic arteries. However, in lower extremity muscular arteries, hypertension (right, P<0.001; left, P<0.001) as well as age (right, P<0.001; left, P<0.001) and gender (right, P=0.009; left, P=0.001) were other significant independent risk factors.

 Conclusion

The PWVs of lower extremity muscular arteries were significantly faster than those of abdominal elastic arteries. The significance of hypertension in faPWV suggests that hypertension is an important risk factor in inducing arterial stiffness, especially in lower extremity muscular arteries.

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Measurement of brachial femoral pulse wave velocity (bfPWV) and femoral ankle pulse wave velocity (faPWV). Lb is the distance between the upper portion of sternum and the sensor of right upper arm cuff. Lf is the distance between the upper portion of sternum and the sensors of right and left upper thigh cuffs. La is the distance between the sensors of right and left upper thigh cuffs and the sensors of right and left ankle cuffs. T0 is the moment of the first appearance of the pulse wave from heart at the sensor of right upper arm cuff. Femoral transit time (ΔTf) is the time spent for the pulse wave to pass the distance equivalent to the difference of Lf and Lb. Ankle transit time (ΔTa) is the time spent for the pulse wave to pass the distance of La. Formulae are bfPWV=[(Lf-Lb)/(ΔTf)]×1,000 (cm/sec) and faPWV=[La/(ΔTa-ΔTf)]×1,000 (cm/sec).

Characteristics of the 184 participants

*95% CI = 95% confidence interval for mean; †BMI = body mass index; ‡LDL = low density lipoprotein; §HDL = high density lipoprotein; ∥TG = triglyceride; HbA1C = hemoglobin A1C; **WBC = number of white blood cell.

Comparison of pulse wave velocities between muscular and elastic arteries

Paired-samples t test. *faPWV = femoral ankle pulse wave velocity; †bfPWV = brachial femoral pulse wave velocity; ‡95% CI = 95% confidence interval.

Correlation between arteriosclerotic risk factors and pulse wave velocities in 184 participants

*faPWV = femoral ankle pulse wave velocity; †bfPWV = brachial femoral pulse wave velocity; ‡C = pearson correlation coefficient; §P-value = Sig. (2-tailed); ∥Gender (male=1, female=2); Smoking (yes=1, no=2); **Hypertension (yes=1, no=2); ††BMI = body mass index (kg/m2); ‡‡LDL = low density lipoprotein; §§HDL = high density lipoprotein; ∥∥TG = triglyceride; ¶¶HbA1C = hemoglobin A1C (%); ***WBC = number of white blood cell.

Predictors for pulse wave velocities in multiple regression analysis

Multiple regression analysis with stepwise method. *faPWV = femoral ankle pulse wave velocity; †bfPWV = brachial femoral pulse wave velocity. Involved variables: age, gender (male=1, female=2), smoking (yes=1, no=2), hypertension (yes=1, n=2).