Comparing the Heart–Thigh and Thigh–Ankle Arteries with the Heart–Ankle Arterial Segment for Arterial Stiffness Measurements

Figures & data

Table 1 Characteristics of the Study Population and Drug Treatments

	Healthy Subjects (n = 90)	Patients with CAD (n = 41)	P-value
Age (years)	54.0 ± 11.5	64.1 ± 10.2	<0.01
Sex (male/female)	35/56	31/10	<0.05
Height (cm)	160.4 ± 9.1	161.9 ± 9.6	n.s.
Weight (kg)	59.0 ± 11.5	65.6 ± 10.1	<0.01
BMI	22.8 ± 2.7	25.0 ± 3.2	<0.01
SBP (mmHg)	125.0 ± 14.2	140.9 ± 18.0	<0.01
DBP (mmHg)	79.2 ± 10.6	84.0 ± 12.0	<0.05
HR (bpm)	66.7 ± 10.4	66.1 ± 12.3	n.s.
Total cholesterol (mg/dL)	213.5 ± 31.3	170.3 ± 31.0	<0.01
LDL cholesterol (mg/dL)	127.1 ± 28.0	95.7 ± 23.2	<0.01
Triglyceride (mg/dL)	118.2 ± 94.6	137.4 ± 17.7	n.s.
HDL cholesterol (mg/dL)	68.0 ± 19.2	50.2 ± 11.3	<0.01
Glucose (mg/dL)	94.1 ± 12.9	113.3 ± 28.5	<0.01
HbA1c (%)	5.43 ± 0.39	5.99 ± 0.76	<0.01
Creatinine (mg/dL)	0.74 ± 0.14	0.92 ± 0.21	<0.01
Uric acid (mg/dL)	5.20 ± 1.21	4.90 ± 1.19	n.s.
Drug treatments
Antihypertensive drug (ACEI, ARB, Ca antagonist)	9 (10.0%)	28 (68.3%)	<0.01
Hypoglycemic drug (metformin, DDP-4 inhibitor, SGL-2 inhibitor)	2 (2.2%)	12 (29.3%)	<0.01
Lipid-lowering drug (statin, fibrates)	6 (6.7%)	35 (85.4%)	<0.01

Notes: Continuous data are shown as mean value ± standard deviation (Student’s t-test). Categorical data are shown as numbers (percentage) (Chi-square test).

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HR, heart rate; LDL, low-density lipoprotein; HDL, high-density lipoprotein; HbA_1c, hemoglobin A_1c; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin II blocker; Ca blocker, calcium antagonist; DDP-4 inhibitor, dipeptidyl peptidase-4 inhibitor; SGL-2 inhibitor, sodium-glucose transporter 2 inhibitor; n.s., non-significant.

Figure 1 Correlation between each segmental β in healthy subjects.

Abbreviations: haBETA, heart–ankle β; htBETA, heart–thigh β; taBETA, thigh–ankle β; r, correlation coefficient.

Figure 2 Correlation between each segmental β in patients with coronary artery disease.

Figure 3 Multiple linear regression model for haBETA with htBETA and taBETA in healthy subjects and patients with coronary artery disease.

Abbreviations: haBETA, heart–ankle β; htBETA, heart–thigh β; taBETA, thigh–ankle β.

Figure 4 Principal component analysis in healthy subjects and patients with coronary artery disease. Component 1: horizontal (relationship between htBETA and haBETA). Component 2: vertical (relationship between taBETA and haBETA).

Abbreviations: haBETA, heart–ankle β; htBETA, heart–thigh β; taBETA, thigh–ankle β.

Table 2 Correlation Coefficient (r) Among htBETA, taBETA, haBETA, and Clinical Characteristics in Healthy Subjects and Patients with CAD

	haBETA	htBETA	taBETA
Thigh circumference
Healthy subjects	0.190	0.134	0.142
Patients with CAD	0.243	0.208	0.042
Age
Healthy subjects	0.626*	0.560*	0.013
Patients with CAD	0.387*	0.406*	0.132
Height
Healthy subjects	0.102	0.165	0.055
Patients with CAD	0.054	0.094	0.009
Body weight
Healthy subjects	0.024	0.096	0.080
Patients with CAD	0.305	0.216	0.065
Body mass index
Healthy subjects	0.121	0.015	0.182
Patients with CAD	0.372^+	0.195	0.042
Systolic blood pressure
Healthy subjects	0.331*	0.297*	0.338*
Patients with CAD	0.166	0.234	0.361^+
Diastolic blood pressure
Healthy subjects	0.224^+	0.181	0.273^+
Patients with CAD	0.225	0.181	0.395^+
Heart rate
Healthy subjects	0.069	0.045	0.137
Patients with CAD	0.112	0.366^+	0.075

Notes: Correlation coefficients (r) are shown. *p < 0.01, ⁺p < 0.05.

Abbreviations: CAD, coronary artery disease; haBETA, heart–ankle β; htBETA, heart–thigh β; taBETA, thigh–ankle β.

Figure 5 Reciever operating characteristic (ROC) curves of haBETA, htBETA, and taBETA in coronary artery disease (CAD). haBETA: cutoff value 9.20 (black arrow), sensitivity 80.5, specificity 63.3%. htBETA: cutoff value 7.72 (dark grey arrow), sensitivity 75.6, specificity 68.9%. taBETA: cutoff value 21.0 (grey arrow), sensitivity 65.6, specificity 45.6%. Each arrow indicates the optimal threshold (cutoff value) of haBETA, htBETA, and taBETA for the discernment of the presence of CAD, respectively. The area under the ROC curve (AUC ± SE) of haBETA, htBETA, and taBETA were 0.731 ± 0.046 (p < 0.01), 0.757 ± 0.043 (p < 0.01), and 0.493 ± 0.054 (p = 0.49), respectively.

Abbreviations: SE, standard error; haBETA, heart–ankle β; htBETA, heart–thigh β; taBETA, thigh–ankle β.

Table 3 htBETA, taBETA, and haBETA in the Healthy Subjects and Patients with CAD

	Healthy Subjects (n = 90)	Patients with CAD (n = 41)	P-value
haBETA	9.22 ± 2.20	10.52 ± 1.58	<0.01
htBETA	7.04 ± 1.95	8.65 ± 1.76	<0.01
taBETA	21.27 ± 8.68*	21.14 ± 8.36*	n.s.

Notes: Data are shown as mean ± standard deviation. Student’s t-test, *p < 0.01 vs haBETA and htBETA.

Abbreviations: CAD, coronary artery disease; haBETA, heart–ankle β; htBETA, heart–thigh β; taBETA, thigh–ankle β; n.s., non-significant.