Background: Pulse wave velocity ratio (PWV-ratio), a measure of central-to-peripheral
arterial stiffness gradient, is calculated as a quotient between carotid-femoral and carotid-radial
PWV (cf-PWV/cr-PWV). This new index has been reported to be significantly associated with increased
mortality in hemodialyzed patients. Since several reports showed differences in arterial
stiffness regarding the pathway where the vascular access (VA) is, the purpose of this research was:
a) to compare arterial stiffness values obtained in the left and right sides of the body in hemodialyzed
and non-hemodialyzed patients, and b) to analyze PWV-ratio values obtained on the side of
the body where the VA was placed and compare them to its contralateral intact side. Since it is difficult
to adequately measure cr-PWV in patients with a VA in the forearm, we measured the carotid-
brachial PWV (cb-PWV) and used it to calculate PWV-ratio (cf-PWV/cb-PWV).
Methods: A Pearson’s correlation and Bland & Altman analysis were performed in hemodialyzed
(n=135) and non-hemodialyzed (n=77) patients, to quantify the equivalence between arterial
stiffness parameters (cf-PWV, cb-PWV, PWV-ratio) obtained on each side of the body with respect
to its contralateral side.
Results: We conclude that PWV-ratio values measured on the side where the VA is placed were
significantly higher than those obtained in its contralateral side, in hemodialyzed patients included
in this research. Moreover, cf-PWV, cb-PWV and PWV-ratio values obtained on one side of the
body were always highly correlated with its contralateral side.
Conclusion: According to this research, any research involving PWV-ratio should always consider
the observed territory.