Shih-Hsien Sung1, Jo-Nan Liao2, Wen-Chung Yu2, Hao-Min Cheng3, Chen-Huan Chen4. 1. Division of Cardiology, Department of Medicine, Taipei, Taiwan, ROC ; Cardiovascular Research Center, Taipei, Taiwan, ROC ; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan, ROC. 2. Division of Cardiology, Department of Medicine, Taipei, Taiwan, ROC ; Cardiovascular Research Center, Taipei, Taiwan, ROC. 3. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC ; Cardiovascular Research Center, Taipei, Taiwan, ROC. 4. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC ; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan, ROC.
Abstract
AIMS: Proximal aortic stiffness may be more important than carotid-femoral pulse wave velocity (cf-PWV) in the pathogenesis of heart failure. The present study investigated the associations of common carotid artery (CCA) stiffness, which might be a surrogate for proximal aortic stiffness, with left ventricular (LV) structure and function, and the development of acute heart failure (AHF). METHODS AND RESULTS: Outpatients without a history of heart failure (114 subjects aged 63.5 ± 17.5 years) were enrolled for comprehensive noninvasive cardiovascular examinations. The LV mass index, the LV ejection fraction (EF), and the ratio of the early diastolic transmitral flow velocity to the early septal mitral annular diastolic velocity (E/E') were measured by echocardiography. CCA mechanical properties, including the incremental elastic modulus (Einc), β stiffness index, CCA distensibility (CD) and circumferential strain (CS), were assessed by carotid artery ultrasonography. cf-PWV was measured by arterial tonometry. CD was significantly associated with the LV mass index, and all CCA stiffness indices were significantly associated with EF and E/E' independently of age, mean blood pressure, and cf-PWV. During a mean follow-up of 265 ± 106 days, 9 patients presented with AHF. Einc (hazard ratio 6.56, 95% confidence interval 1.64-26.26, by quartile analysis), CS (6.82, 1.70-27.35), and β stiffness index (3.91, 1.05-14.57) but not cf-PWV (1.62, 0.41-6.51) significantly predicted the events. CONCLUSIONS: In patients at risk for heart failure, CCA stiffness was significantly associated with LV structure and function independently of cf-PWV. In addition, CCA stiffness but not cf-PWV predicted first AHF.
AIMS: Proximal aortic stiffness may be more important than carotid-femoral pulse wave velocity (cf-PWV) in the pathogenesis of heart failure. The present study investigated the associations of common carotid artery (CCA) stiffness, which might be a surrogate for proximal aortic stiffness, with left ventricular (LV) structure and function, and the development of acute heart failure (AHF). METHODS AND RESULTS: Outpatients without a history of heart failure (114 subjects aged 63.5 ± 17.5 years) were enrolled for comprehensive noninvasive cardiovascular examinations. The LV mass index, the LV ejection fraction (EF), and the ratio of the early diastolic transmitral flow velocity to the early septal mitral annular diastolic velocity (E/E') were measured by echocardiography. CCA mechanical properties, including the incremental elastic modulus (Einc), β stiffness index, CCA distensibility (CD) and circumferential strain (CS), were assessed by carotid artery ultrasonography. cf-PWV was measured by arterial tonometry. CD was significantly associated with the LV mass index, and all CCA stiffness indices were significantly associated with EF and E/E' independently of age, mean blood pressure, and cf-PWV. During a mean follow-up of 265 ± 106 days, 9 patients presented with AHF. Einc (hazard ratio 6.56, 95% confidence interval 1.64-26.26, by quartile analysis), CS (6.82, 1.70-27.35), and β stiffness index (3.91, 1.05-14.57) but not cf-PWV (1.62, 0.41-6.51) significantly predicted the events. CONCLUSIONS: In patients at risk for heart failure, CCA stiffness was significantly associated with LV structure and function independently of cf-PWV. In addition, CCA stiffness but not cf-PWV predicted first AHF.
Entities:
Keywords:
Acute heart failure; Arterial stiffness; Common carotid artery; Left ventricular function; Speckle tracking
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