Functional Markers of Vascular Aging: Subendocardial Viability Ratio, Augmentation Pressure, and Augmentation Index as Links to Atherosclerotic Cardiovascular Disease Risk.

This study investigated the correlation of functional hemodynamic parameters, including subendocardial viability ratio (SEVR), augmentation pressure (AP) and heart-rate-corrected augmentation index (Aix@75), with age and atherosclerotic cardiovascular disease (ASCVD) risk in a Chinese population. A total of 3,354 participants aged 18-80 years with left ventricular ejection fraction >55% were enrolled in this cross-sectional study. Functional hemodynamic parameters were assessed by pulse wave analysis, and the 10-year ASCVD risk (10Y-ASCVDR) was estimated using the China-PAR model. Multivariable logistic regression was used to identify independent correlates of elevated estimated 10Y-ASCVDR. Results showed that 10Y-ASCVDR was inversely correlated with SEVR (r = -0.171, p < 0.001) and positively correlated with AP (r = 0.452, p < 0.001) and Aix@75 (r = 0.236, p < 0.001). Stepwise multivariable linear regression identified SEVR, AP and Aix@75 as independent correlates of estimated 10-year ASCVD risk (p < 0.001). In conclusion, SEVR, AP and Aix@75 are independent correlates of estimated 10-year ASCVD risk, and together provide a functional hemodynamic profile that independently correlates with estimated risk beyond traditional factors, suggesting their potential role as supplementary tools for cardiovascular risk stratification. These findings offer a valuable supplemental approach for improving cardiovascular risk assessment in clinical practice.