Abstract
Introduction: Noninvasive measurement of arterial stiffness by pulse-wave velocity (PWV) has prognostic value in different sub groups of cardiovascular disorders. We aimed to measure the PWV in advanced heart failure (HF) patients with reduced left ventricular ejection fraction (LVEF) and investigate whether it has any prognostic significance in this group of patients. Methods: Between 2013 to 2015 patients with a diagnosis of advanced HF (LVEF ≤ 30%) scheduled for right heart catheterization (RHC) were included in our study. PWV was measured before RHC in each patient using vascular explorer device (Enverdis GmbH) in catheterization laboratory. The patients were subsequently followed for 6 months and their hospitalization or death (composite of all-cause death/hospitalization) were recorded. Results: A total of 50 patients (38 men) were enrolled. The mean (SD) of age was 45 (16) years. The mean PWV was 6.8 m/s. There was no statistically significant correlation between the PWV and the clinical, echocardiographic and RHC data. The PWV was not different in patients with or without composite of all-cause death/hospitalization (7.3 versus 6.3, P > 0.05). In this study cardiac output (CO) (beta = -0.53, P = 0.02, odds ratio = 0.6, 95% CI = 0.4-0.9), pulse pressure (PP) (beta = -0056, P = 0.03, odds ratio=0.95, 95% CI = 0.89-0.99) and age (beta = -0.045, P = 0.05, odds ratio = 0.96, 95% CI = 0.9-1.001) were independent predictors of composite of all-cause death/ hospitalization. Conclusion: In patients with advanced systolic HF, PWV may not be a good prognostic factor and does not have any added value over previous well known prognostic factors.
Highlights
Noninvasive measurement of arterial stiffness by pulse-wave velocity (PWV) has prognostic value in different sub groups of cardiovascular disorders
Some of these studies show that PWV is associated with peak VO2, level of pro-brain natriuretic peptide (BNP) and mortality in patients with heart failure (HF) including those with systolic HF.3,13-16
This study showed that PWV may not be a useful prognostic factor in patients with advanced HF who are on guideline directed medical therapy
Summary
Noninvasive measurement of arterial stiffness by pulse-wave velocity (PWV) has prognostic value in different sub groups of cardiovascular disorders. We aimed to measure the PWV in advanced heart failure (HF) patients with reduced left ventricular ejection fraction (LVEF) and investigate whether it has any prognostic significance in this group of patients. Several studies have shown that the PWV is a predictor of cardiovascular and all cause of mortality in a variety of cardiovascular disorders.. We sought to measure the PWV value in advanced HF patients with reduced left ventricular ejection fraction (LVEF) who were candidate for right heart catheterization (RHC) and investigate whether PWV had any association with prognostic factors in advanced HF patients PWV is the gold standard method for measuring arterial stiffness. Several studies have shown that the PWV is a predictor of cardiovascular and all cause of mortality in a variety of cardiovascular disorders. Some of these studies show that PWV is associated with peak VO2, level of pro-brain natriuretic peptide (BNP) and mortality in patients with HF including those with systolic HF. In this study, we sought to measure the PWV value in advanced HF patients with reduced left ventricular ejection fraction (LVEF) who were candidate for right heart catheterization (RHC) and investigate whether PWV had any association with prognostic factors in advanced HF patients
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