Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study
Background: Heart failure with preserved ejection fraction (HFpEF) is the most common cardiac complication in patients with coronary microvascular dysfunction (CMD), yet its underlying pathways remain unclear. Aortic pulse-wave velocity (aPWV) is an indicator of large artery stiffness and a predicto...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-05-01
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| Series: | American Heart Journal Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602224000338 |
| _version_ | 1797199868950740992 |
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| author | P. Rezaeian C.L. Shufelt J. Wei C. Pacheco G. Cook-Wiens D. Berman B. Tamarappoo L.E. Thomson M.D. Nelson R.D. Anderson J. Petersen E.M. Handberg C.J. Pepine C.N. Bairey Merz |
| author_facet | P. Rezaeian C.L. Shufelt J. Wei C. Pacheco G. Cook-Wiens D. Berman B. Tamarappoo L.E. Thomson M.D. Nelson R.D. Anderson J. Petersen E.M. Handberg C.J. Pepine C.N. Bairey Merz |
| author_sort | P. Rezaeian |
| collection | DOAJ |
| description | Background: Heart failure with preserved ejection fraction (HFpEF) is the most common cardiac complication in patients with coronary microvascular dysfunction (CMD), yet its underlying pathways remain unclear. Aortic pulse-wave velocity (aPWV) is an indicator of large artery stiffness and a predictor for cardiovascular disease. However, aPWV in CMD and HFpEF is not well characterized and may provide understanding of disease progression. Methods: Among participants without obstructive coronary artery disease, we evaluated 51 women with suspected CMD and 20 women and men with evidence of HFpEF. All participants underwent aPWV measurement (SphygmoCor, Atcor Medical) with higher aPWV indicating greater vascular stiffness. Cardiac magnetic resonance imaging (CMRI) assessed left ventricular (LV) ejection fraction, CMD via myocardial perfusion reserve index (MPRI), and ventricular remodeling via LV mass-volume ratio. . Statistical analysis was performed using Wilcoxon rank sum tests, Pearson correlations and linear regression analysis. Results: Compared to the suspected CMD group, the HFpEF participants were older (65 ± 12 vs 56 ± 11 yrs., p = 0.002) had higher BMI (31.0 ± 4.3 vs 27.8 ± 6.7 kg/m2, p = 0.013), higher aPWV (10.5 ± 2.0 vs 8.0 ± 1.6 m/s, p = 0.05) and lower MPRI (1.5 ± 0.3 vs1.8 ± 0.3, p = 0.02), but not remodeling. In a model adjusted for cardiovascular risk factors, the HFpEF group had a lower LVEF (estimate −4.78, p = 0.0437) than the suspected CMD group. Conclusions: HFpEF participants exhibit greater arterial stiffness and lower myocardial perfusion reserve, with lower LVEF albeit not remodeling, compared to suspected CMD participants. These findings suggest arterial stiffness may contribute to progression from CMD to HFpEF. Prospective work is needed and ongoing. |
| first_indexed | 2024-04-24T07:22:36Z |
| format | Article |
| id | doaj.art-edc125ccd15142cea41b9a62ba25f83d |
| institution | Directory Open Access Journal |
| issn | 2666-6022 |
| language | English |
| last_indexed | 2024-04-24T07:22:36Z |
| publishDate | 2024-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj.art-edc125ccd15142cea41b9a62ba25f83d2024-04-21T04:14:33ZengElsevierAmerican Heart Journal Plus2666-60222024-05-0141100390Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation studyP. Rezaeian0C.L. Shufelt1J. Wei2C. Pacheco3G. Cook-Wiens4D. Berman5B. Tamarappoo6L.E. Thomson7M.D. Nelson8R.D. Anderson9J. Petersen10E.M. Handberg11C.J. Pepine12C.N. Bairey Merz13Torrance Memorial Medical Center-A Cedars-Sinai Affiliate, Torrance, CA, USADivision of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USABarbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USAHôspital Pierre-Boucher, Centre Hospitalier de l'Université de Montréal, Université de Montreal, QC, CanadaTorrance Memorial Medical Center-A Cedars-Sinai Affiliate, Torrance, CA, USATaper Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USATaper Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USATaper Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USAThe University of Texas at Arlington, Arlington, TX, USADivision of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USADivision of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USADivision of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USADivision of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USABarbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA; Corresponding author at: Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, 127 S San Vicente Blvd, AHSP Suite A3206, Los Angeles, CA 90048, USA.Background: Heart failure with preserved ejection fraction (HFpEF) is the most common cardiac complication in patients with coronary microvascular dysfunction (CMD), yet its underlying pathways remain unclear. Aortic pulse-wave velocity (aPWV) is an indicator of large artery stiffness and a predictor for cardiovascular disease. However, aPWV in CMD and HFpEF is not well characterized and may provide understanding of disease progression. Methods: Among participants without obstructive coronary artery disease, we evaluated 51 women with suspected CMD and 20 women and men with evidence of HFpEF. All participants underwent aPWV measurement (SphygmoCor, Atcor Medical) with higher aPWV indicating greater vascular stiffness. Cardiac magnetic resonance imaging (CMRI) assessed left ventricular (LV) ejection fraction, CMD via myocardial perfusion reserve index (MPRI), and ventricular remodeling via LV mass-volume ratio. . Statistical analysis was performed using Wilcoxon rank sum tests, Pearson correlations and linear regression analysis. Results: Compared to the suspected CMD group, the HFpEF participants were older (65 ± 12 vs 56 ± 11 yrs., p = 0.002) had higher BMI (31.0 ± 4.3 vs 27.8 ± 6.7 kg/m2, p = 0.013), higher aPWV (10.5 ± 2.0 vs 8.0 ± 1.6 m/s, p = 0.05) and lower MPRI (1.5 ± 0.3 vs1.8 ± 0.3, p = 0.02), but not remodeling. In a model adjusted for cardiovascular risk factors, the HFpEF group had a lower LVEF (estimate −4.78, p = 0.0437) than the suspected CMD group. Conclusions: HFpEF participants exhibit greater arterial stiffness and lower myocardial perfusion reserve, with lower LVEF albeit not remodeling, compared to suspected CMD participants. These findings suggest arterial stiffness may contribute to progression from CMD to HFpEF. Prospective work is needed and ongoing.http://www.sciencedirect.com/science/article/pii/S2666602224000338Heart failure with preserve ejection fractionPulse wave velocityDiastolic function |
| spellingShingle | P. Rezaeian C.L. Shufelt J. Wei C. Pacheco G. Cook-Wiens D. Berman B. Tamarappoo L.E. Thomson M.D. Nelson R.D. Anderson J. Petersen E.M. Handberg C.J. Pepine C.N. Bairey Merz Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study American Heart Journal Plus Heart failure with preserve ejection fraction Pulse wave velocity Diastolic function |
| title | Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study |
| title_full | Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study |
| title_fullStr | Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study |
| title_full_unstemmed | Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study |
| title_short | Arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction: An initial report from the WISE-CVD continuation study |
| title_sort | arterial stiffness assessment in coronary microvascular dysfunction and heart failure with preserved ejection fraction an initial report from the wise cvd continuation study |
| topic | Heart failure with preserve ejection fraction Pulse wave velocity Diastolic function |
| url | http://www.sciencedirect.com/science/article/pii/S2666602224000338 |
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