Devices, systems, and methods for pulse wave velocity determination are disclosed. The apparatus includes an intravascular device that can be positioned within a vessel. The intravascular device includes a flexible elongate member having a proximal portion and a distal portion. A pressure sensor can be coupled to the distal portion of the flexible elongate member. The pressure sensor can monitor pressure within the vessel. At least one imaging element can be coupled to the distal portion of the flexible elongate member. The imaging element can monitor the wall thickness of the vessel. A processing system in communication with the intravascular device can control the monitoring of the pressure and the monitoring of the wall thickness of the vessel. The processing system can receive pressure data and wall thickness data and determine a pulse wave velocity of fluid within the vessel.
