11.9 PARAMETERS OF ARTERIAL STIFFNESS HAVE INDEPENDENT PROGNOSTIC VALUE IN STABLE PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION
The purpose of the study was to determine the prognostic value of ventricular-arterial coupling (VAC) in patients with arterial hypertension (AH) and stable heart failure with reduced ejection fraction (HFrEF). Methods: In prospective study (follow-up 12–24 months, median 18 months) prognosis of 93...
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| Format: | Article |
| Language: | English |
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BMC
2016-11-01
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| Series: | Artery Research |
| Online Access: | https://www.atlantis-press.com/article/125930473/view |
| _version_ | 1818475301234016256 |
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| author | Evgeny Tyukhmenev Svetlana Villevalde Zhanna Kobalava |
| author_facet | Evgeny Tyukhmenev Svetlana Villevalde Zhanna Kobalava |
| author_sort | Evgeny Tyukhmenev |
| collection | DOAJ |
| description | The purpose of the study was to determine the prognostic value of ventricular-arterial coupling (VAC) in patients with arterial hypertension (AH) and stable heart failure with reduced ejection fraction (HFrEF).
Methods: In prospective study (follow-up 12–24 months, median 18 months) prognosis of 93 stable patients with controlled hypertension and HFrEF was evaluated. Adverse outcomes included all cause death or first HF hospitalization. 2-dimentional echocardiography was used to assess arterial elastance (Ea) and end-systolicLV elastance (Ees). VAC was assessed as the ratio Ea/Ees. Arterial stiffness was assessed using applanation tonometry. Clinical and demographic parameters, parameters of LV function, VAC and arterial stiffness were included in multivariate analysis. P<0.05 was considered significant.
Results: Adverse outcomes were revealed in 39% of patients (15% deaths, 24% HF hospitalizations). The following factors increased the risk of adverse outcomes: LVEF <25%, index of VAC 33.3, stroke work (SW)/pressure volume area (PVA) (LV work efficiency) <38%, augmentation index (AI) ≥25%, time to reflected wave(Tr) <135. Pulse wave velocity ≥15 m/s, office systolic BP <120 mmHg were associated with increased risk of HF hospitalizations. AI >35%, office systolic BP <120 and diastolic BP <70, Tr <116, SW/PVA <48% were associated with increased risk of all-cause death.
Conclusions: Parameters of VAC and arterial stiffness have independent prognostic value as well as LVEF and BP in patients with AH and HFrEF. Assessment of VAC via Ea/Elv, an additional noninvasively derived metric, can be used for risk stratification of patients with HFrEF. |
| first_indexed | 2024-12-10T09:11:10Z |
| format | Article |
| id | doaj.art-ea89b099a5e7491d98716f410bdbf3c4 |
| institution | Directory Open Access Journal |
| issn | 1876-4401 |
| language | English |
| last_indexed | 2024-12-10T09:11:10Z |
| publishDate | 2016-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Artery Research |
| spelling | doaj.art-ea89b099a5e7491d98716f410bdbf3c42022-12-22T01:55:01ZengBMCArtery Research1876-44012016-11-011610.1016/j.artres.2016.10.09711.9 PARAMETERS OF ARTERIAL STIFFNESS HAVE INDEPENDENT PROGNOSTIC VALUE IN STABLE PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTIONEvgeny TyukhmenevSvetlana VillevaldeZhanna KobalavaThe purpose of the study was to determine the prognostic value of ventricular-arterial coupling (VAC) in patients with arterial hypertension (AH) and stable heart failure with reduced ejection fraction (HFrEF). Methods: In prospective study (follow-up 12–24 months, median 18 months) prognosis of 93 stable patients with controlled hypertension and HFrEF was evaluated. Adverse outcomes included all cause death or first HF hospitalization. 2-dimentional echocardiography was used to assess arterial elastance (Ea) and end-systolicLV elastance (Ees). VAC was assessed as the ratio Ea/Ees. Arterial stiffness was assessed using applanation tonometry. Clinical and demographic parameters, parameters of LV function, VAC and arterial stiffness were included in multivariate analysis. P<0.05 was considered significant. Results: Adverse outcomes were revealed in 39% of patients (15% deaths, 24% HF hospitalizations). The following factors increased the risk of adverse outcomes: LVEF <25%, index of VAC 33.3, stroke work (SW)/pressure volume area (PVA) (LV work efficiency) <38%, augmentation index (AI) ≥25%, time to reflected wave(Tr) <135. Pulse wave velocity ≥15 m/s, office systolic BP <120 mmHg were associated with increased risk of HF hospitalizations. AI >35%, office systolic BP <120 and diastolic BP <70, Tr <116, SW/PVA <48% were associated with increased risk of all-cause death. Conclusions: Parameters of VAC and arterial stiffness have independent prognostic value as well as LVEF and BP in patients with AH and HFrEF. Assessment of VAC via Ea/Elv, an additional noninvasively derived metric, can be used for risk stratification of patients with HFrEF.https://www.atlantis-press.com/article/125930473/view |
| spellingShingle | Evgeny Tyukhmenev Svetlana Villevalde Zhanna Kobalava 11.9 PARAMETERS OF ARTERIAL STIFFNESS HAVE INDEPENDENT PROGNOSTIC VALUE IN STABLE PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION Artery Research |
| title | 11.9 PARAMETERS OF ARTERIAL STIFFNESS HAVE INDEPENDENT PROGNOSTIC VALUE IN STABLE PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION |
| title_full | 11.9 PARAMETERS OF ARTERIAL STIFFNESS HAVE INDEPENDENT PROGNOSTIC VALUE IN STABLE PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION |
| title_fullStr | 11.9 PARAMETERS OF ARTERIAL STIFFNESS HAVE INDEPENDENT PROGNOSTIC VALUE IN STABLE PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION |
| title_full_unstemmed | 11.9 PARAMETERS OF ARTERIAL STIFFNESS HAVE INDEPENDENT PROGNOSTIC VALUE IN STABLE PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION |
| title_short | 11.9 PARAMETERS OF ARTERIAL STIFFNESS HAVE INDEPENDENT PROGNOSTIC VALUE IN STABLE PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION |
| title_sort | 11 9 parameters of arterial stiffness have independent prognostic value in stable patients with heart failure with reduced ejection fraction |
| url | https://www.atlantis-press.com/article/125930473/view |
| work_keys_str_mv | AT evgenytyukhmenev 119parametersofarterialstiffnesshaveindependentprognosticvalueinstablepatientswithheartfailurewithreducedejectionfraction AT svetlanavillevalde 119parametersofarterialstiffnesshaveindependentprognosticvalueinstablepatientswithheartfailurewithreducedejectionfraction AT zhannakobalava 119parametersofarterialstiffnesshaveindependentprognosticvalueinstablepatientswithheartfailurewithreducedejectionfraction |