Impaired Arterial Elasticity Identified by Pulse Waveform Analysis is a Non- invasive Measure for Early Detection of Endothelial Dysfunction

Objectives Endothelial dysfunction is the earliest marker for atherosclerosis and plays key role in the pathogenesis of cardiovascular diseases. The present study was performed to evaluate effect of aging on arterial elasticity by using pulse waveform analysis and investigate whether the changes in arterial elasticity can be used as a non - invasive measure for early detection of endothelial dysfunction.Methods Using modified Windkessel model of the circulation and pulse waveform analysis, C1 large artery and C2 small artery elasticity indices of 204 normal healthy subjects ( age 15 -80 years) were measured.Among them twenty - four male healthy subjects were divided into both the young (age 20 -30 years, n =12) and elderly (age 60 - 70 years, n = 12) groups.We delivered acethycholine (Ach), an endotheliumdependent vasodilator, and sodium nitroprusside(SNP), an endothelium- independent vasodilator, to dermal vessels of the forearm using iontophoresis, respectively, and measured basal and peak blood flow using laser doppler fluximetry. Results C1 large artery and C2 small artery elasticity indices were reduced with advancing age. C 1 large artery and C2 small artery elasticity indices were negatively correlated with age (r= -0.628, p＜0.001; r= -0.595, p ＜0.001).Basal blood flow was similar between the young and elderly groups ( 14.58 ± 3.4 vs 13.52 ± 3.41 PU, p =NS). Peak blood flow induced by Ach was significantly reduced in the elderly group compared with the young group (83.4 ± 11.9 vs 93.75 ± 10. 87 PU, p ＜ 0. 05 ).However, peak blood flow induced by SNP was similar in the two groups ( 119. 17 ± 16.76 vs 128.33 ± 21.29 PU,p = NS). Ach - induced peak blood flow correlated positively with C1 large artery and C2 small artery elasticity indices( r=0.56, p ＜0.01; r =0.53, p ＜0.01).Conclusions Advancing age leads to impaired artery elasticity and endothelial dysfun ction. Reduced arterial elasticity is, in parallel, associated with diminished endothelium- dependent vasodilation. It is concluded that a