A new method for cerebral arterial stiffness by measuring pulse wave velocity using transcranial doppler

Aim: Pulse wave velocity (PWV) has been regarded as the “gold standard” measurement of arterial stiffness (AS), but it is still only used in the assessment of central and peripheral arteries. We constructed a new method to evaluate cerebral AS by measuring PWV using transcranial Doppler (TCD). Methods: In all, 90 healthy subjects who received annual health screening were consecutively enrolled in this study between January 2011 and June 2013. Data on clinical characteristics, brachium-ankle (ba) PWV, and carotid-cerebral (cc) PWV measured with our newly constructed method by two experienced operators were recorded. cc PWV was calculated as the distance between two points in the common carotid artery and proximal part of ipsilateral middle cerebral artery, which was divided by the pulse transit time between these two points where the pulse was measured using TCD. Results: The value of cc PWV was 499.3±78.6 cm/s. Correlation between cc PWV and ba PWV in the assessment of AS was r =0.794 (P<0.001). The concordance between both the above mentioned methods was good. Interobserver and intraobserver reliability using interclass correlation for measuring cc PWV were 0.815 (P<0.001) and 0.939 (P<0.001), respectively. In multivariable analysis, older age (β= 4.51, P<0.001) and increased diastolic blood pressure (β= 2.39, P<0.001) were independently associated with higher cc PWV. Conclusion: cc PWV measured using TCD may be a promising method for the assessment of human cerebral AS, which is independently associated with age and diastolic blood pressure.