Brachial-Ankle Pulse Wave Velocity, Mortality, and Cardiovascular Events

Pulse Wave Velocity (PWV) is used as an index of arterial stiffness worldwide. One standard PWV is the carotid-femoral PWV (cfPWV). Articles reporting the usefulness of brachial-ankle PWV (baPWV), which is measured at the brachium and ankle, are rapidly increasing.And the number of prognosis follow-up studies is approaching 40. Observing these reports, baPWV shows a prognostic predictability independent from classic atherosclerotic risk factors that are considered to improve upon the exclusion of patients with Peripheral Arterial Disease (PAD). On the other hand, it is difficult to exclude PAD only by the ordinal cut-off of ABI 0.9, especially in populations of patients with diabetes or those on hemodialysis. In this review, we summarize previously reported articles, identify the efficacy of baPWV in the various reports, consider why the predictability of baPWV is decreased in those populations, suggest possible solutions to avoid the use of inaccurate baPWV measurements, and present future perspectives.