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Accuracy of Pulse Wave Velocity Predicting Cardiovascular and All-Cause Mortality. A Systematic Review and Meta-Analysis

1
Universidad de Castilla-La Mancha, Health and Social Research Center, 16071 Cuenca, Spain
2
Universidad Politécnica y Artística del Paraguay, Asunción 001518, Paraguay
3
Faculty of Physiotherapy and Nursing of Toledo, University of Castilla-La Mancha, 45005 Toledo, Spain
4
Multidisciplinary Research Group in Care (IMCU), University of Castilla-La Mancha, 45005 Toledo, Spain
5
Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3467987, Chile
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2080; https://doi.org/10.3390/jcm9072080
Received: 27 May 2020 / Revised: 24 June 2020 / Accepted: 29 June 2020 / Published: 2 July 2020
(This article belongs to the Section Vascular Medicine)
Increased arterial stiffness has been associated with an increased risk of developing cardiovascular diseases and all-cause mortality. Pulse wave velocity (PWV) is an innovative and affordable measurement of arterial stiffness which may be an accessible tool to estimate mortality risk; however, no meta-analysis has estimated its predictive performance for cardiovascular and all-cause mortality. Moreover, reference values for PWV have only been established by consensus for healthy populations. The aim of this review was to estimate PWV and especially carotid femoral PWV performance predicting cardiovascular and all-cause mortality as well as comparing the resulting cfPWV thresholds with already established values in order to increase its validity. Original studies measuring PWV thresholds and its association with cardiovascular and all-cause mortality were systematically searched. The DerSimonian and Laird method was used to compute pooled estimates of diagnostic odds ratio (dOR), and overall test performances were summarized in hierarchical summary receiver operating characteristic curves (HSROC). Six studies were included in the meta-analysis. The pooled dOR values for the predictive performance of cfPWV were 11.23 (95 % CI, 7.29–1.29) for cardiovascular mortality and 6.52 (95% CI, 4.03–10.55) for all-cause mortality. The area under the HSROC curve for cfPWV was 0.75 (95% CI, 0.69–0.81) for cardiovascular mortality and 0.78 (95% CI, 0.74–0.83) for all-cause mortality, where the closest cut-off point to the summary point was 10.7 and 11.5, respectively. This systematic review and meta-analysis demonstrates that cfPWV is a useful and accurate cardiovascular mortality predictor and that its previously estimated reference values for estimating risk may be used in high-risk populations. View Full-Text
Keywords: arterial stiffness; pulse wave velocity; predictive performance; cardiovascular risk; cardiovascular mortality; all-cause mortality arterial stiffness; pulse wave velocity; predictive performance; cardiovascular risk; cardiovascular mortality; all-cause mortality
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Sequí-Domínguez, I.; Cavero-Redondo, I.; Álvarez-Bueno, C.; Pozuelo-Carrascosa, D.P.; Nuñez de Arenas-Arroyo, S.; Martínez-Vizcaíno, V. Accuracy of Pulse Wave Velocity Predicting Cardiovascular and All-Cause Mortality. A Systematic Review and Meta-Analysis. J. Clin. Med. 2020, 9, 2080.

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