Clinical significance of brachial–ankle pulse-wave velocity in patients with heart failure with preserved left ventricular ejection fraction

Tokitsu, Takanori; Yamamoto, Eiichiro; Oike, Fumi; Hirata, Yoshihiro; Tsujita, Kenichi; Yamamuro, Megumi; Kaikita, Koichi; Hokimoto, Seiji

doi:10.1097/hjh.0000000000001589

Cited by 29 publications

(26 citation statements)

References 27 publications

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“…An incident HF diagnosis was carried out by a specialist and was based on clinical assessment, chest X-ray, and echocardiography [26]. Incident CVD was defined as the composite of coronary revascularization, unstable angina pectoris, and nonfatal myocardial infarction [27]. During the 2-year follow-up, all subjects were administered the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ), which are two widely used disease-specific quality-of-life measures for patients with HF [28,29].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical data were summarized as percentages for categorical variables and as the mean ± standard deviation (SD) for continuous variables. The sample size was calculated based on previous studies [27,30] and 80% power. Comparisons between all variables from multiple groups were assessed by the χ 2 test, Kruskal-Wallis test, or one-way ANOVA.…”

Section: Discussionmentioning

confidence: 99%

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Trajectories of Waist-to-Hip Ratio and Adverse Outcomes in Heart Failure with Mid-Range Ejection Fraction

Gao

Wan

et al. 2020

Obes Facts

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Background: Waist-to-hip ratio (WHR) is a strong predictor of mortality in patients with heart failure (HF). However, common WHR trajectories are not well established in HF with mid-range ejection fraction (HFmrEF) persons, and their relationship to clinical outcomes remains uncertain. Method: We prospectively enrolled 1,396 participants with HFmrEF (left ventricular ejection fraction 40-49%) from April 2013 through April 2017. The waist and hip circumferences of the subjects were measured at regular intervals, and the WHR was calculated as waist circumference divided by hip circumference. Latent mixture modeling was performed to identify WHR trajectories. We then used Cox proportional-hazard models to examine the association between WHR trajectory patterns and incident HF, incident cardiovascular disease (CVD), and all-cause mortality. Results: We identified four distinct WHR trajectory patterns: leanmoderate increase (9.2%), medium-stable/increase (32.7%), heavy-stable/increase (48.0%), and heavy-moderate decrease (10.1%). After multivariable adjustment, the heavy-stable/increase and heavy-moderate decrease patterns were associated with an increased all-cause mortality risk (heavy-stable/increase: adjusted hazard ratio [HR] 3.18, 95% confidence interval [CI] 2.75-4.62; heavy-moderate decrease: adjusted HR 2.32, 95% CI 1.71-3.04), incident CVD risk (heavy-stable/increase: adjusted HR 4.03, 95% CI 2.39-4.91; heavy-moderate decrease:

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Trajectories of Waist-to-Hip Ratio and Adverse Outcomes in Heart Failure with Mid-Range Ejection Fraction

Gao

Wan

et al. 2020

Obes Facts

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“…A recent study reported that a low baPWV and a high baPWV predict a worse prognosis in patients with heart failure and preserved ejection function. 24 Therefore, when using baPWV in cohorts with severe disease conditions in both clinical and research settings, diseases such as ASO and arrhythmia, should not only be excluded but a specific exclusion criteria should also be considered. 8…”

Section: Discussionmentioning

confidence: 99%

Pitfalls in the ankle-brachial index and brachial-ankle pulse wave velocity

Ato¹

2018

VHRM

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BackgroundThe ankle-brachial index (ABI) and pulse wave velocity (PWV) are indices of atherosclerosis and arterial stiffness. The Japan-made measuring devices of those indices have spread widely because of their convenience and the significance of the parameters. However, studies that comprehensively discuss the various pitfalls in using these indices are not available.MethodsThis study presents several representative pitfalls in using the ABI and brachial-ankle PWV (baPWV) by showing the result sheets of the device, “the Vascular Profiler”. Furthermore, some considerations when utilizing these indices in the future are also discussed.ResultsSeveral diseases such as arteriosclerosis obliterans (ASO), arterial calcification in the lower limb, arterial stenosis in the right upper-limb, aortic valve diseases, arterial stenosis in the upper-limb of the contralateral side of the hemodialysis access, are the representative pitfalls when evaluating ABI and baPWV. Moreover, a measurement error is found to actually exist. Furthermore, same phenomena are considered most likely to occur when using other similar indices and devices.ConclusionThe ABI and baPWV are the useful and significant biomarkers. Nevertheless, caution is sometimes necessary when interpreting them. Moreover, rigorous patient exclusion criteria should be considered when using those indices in the severely conditioned patient population. And the results of this study can be applied to enhance the literacy using other indices, such as the cardio-ankle vascular index and other similar devices.

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“…When the terms brachial-ankle PWV and cardiovascular events/prognosis were entered as key words in PubMED, a total of 55 studies examining the usefulness of the brachial-ankle PWV as a marker to predict future cardiovascular events or prognosis were found. Among these, 22 had been conducted in subjects without a history of CVD and 23 had been conducted in subjects with CVD (including CKD) (i.e., 11 studies on CKD, 14 studies on coronary artery disease, 3 studies on heart failure, and 6 studies on cerebrovascular disease) 69 , 70 , 84 – 136 ) . These studies confirmed the usefulness of brachial-ankle PWV as a predictor of the risk of cardiovascular disease.…”

Section: Is Brachial-ankle Pwv Useful For Cardiovascular Risk Stratifmentioning

confidence: 99%

State of the Art Review: Brachial-Ankle PWV

Tomiyama

Shiina

2020

JAT

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The brachial-ankle pulse wave velocity (brachial-ankle PWV), which is measured simply by wrapping pressure cuffs around the four extremities, is a simple marker to assess the stiffness of the medium- to large- sized arteries. The accuracy and reproducibility of its measurement have been confirmed to be acceptable. Risk factors for cardiovascular disease, especially advanced age and high blood pressure, are reported to be associated with an increase of the arterial stiffness. Furthermore, arterial stiffness might be involved in a vicious cycle with the development/progression of hypertension, diabetes mellitus and chronic kidney disease. Increase in the arterial stiffness is thought to contribute to the development of cardiovascular disease via pathophysiological abnormalities induced in the heart, brain, kidney, and also the arteries themselves. A recent independent participant data meta-analysis conducted in Japan demonstrated that the brachial-ankle PWV is a useful marker to predict future cardiovascular events in Japanese subjects without a previous history of cardiovascular disease, independent of the conventional model for the risk assessment. The cutoff point may be 16.0 m/s in individuals with a low risk of cardiovascular disease (CVD), and 18.0 m/s in individuals with a high risk of CVD and subjects with hypertension. In addition, the method of measurement of the brachial-ankle PWV can also be used to calculate the inter-arm systolic blood pressure difference and ankle-brachial pressure index, which are also useful markers for cardiovascular risk assessment.

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Clinical significance of brachial–ankle pulse-wave velocity in patients with heart failure with preserved left ventricular ejection fraction

Abstract: Identifying complications of PAD and measuring baPWV values in HFpEF patients can improve risk stratification.

Cited by 29 publications

References 27 publications

Trajectories of Waist-to-Hip Ratio and Adverse Outcomes in Heart Failure with Mid-Range Ejection Fraction

Trajectories of Waist-to-Hip Ratio and Adverse Outcomes in Heart Failure with Mid-Range Ejection Fraction

Pitfalls in the ankle-brachial index and brachial-ankle pulse wave velocity

State of the Art Review: Brachial-Ankle PWV

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