Opposite Predictive Value of Pulse Pressure and Aortic Pulse Wave Velocity on Heart Failure With Reduced Left Ventricular Ejection Fraction

Régnault, V.; Lagrange, Jérémy; Pizard, Anne; Safar, Michel E.; Fay, Renaud; Pitt, Bertram; Challande, Pascal; Rossignol, Patrick; Zannad, Faı̈ez; Lacolley, Patrick

doi:10.1161/hypertensionaha.113.02046

Cited by 84 publications

(30 citation statements)

References 34 publications

(34 reference statements)

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“…1). Nevertheless, the prognostic value of PWV in patients with heart failure might be limited as absolute PWV levels may be misleading due to reduced ejection fraction and BP [44,45]. The validation of PWV in patients with atrial fibrillation remains unclear and needs further investigation [46,47].…”

Section: Discussionmentioning

confidence: 99%

Comparison of 24-hour and Office Pulse Wave Velocity for Prediction of Mortality in Hemodialysis Patients

et al. 2019

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Background: Mortality in hemodialysis patients still remains unacceptably high. Enhanced arterial stiffness is a known cardiovascular risk factor, and pulse wave velocity (PWV) has proven to be a valid parameter to quantify risk. Recent studies showed controversial results regarding the prognostic significance of PWV for mortality in hemodialysis patients, which may be due to methodological issues, such as assessment of PWV in the office setting (Office-PWV). Method: This study cohort contains patients from the “Risk stratification in end-stage renal disease – the ISAR study,” a multicenter prospective longitudinal observatory cohort study. We examined and compared the predictive value of ambulatory 24-hour PWV (24 h-PWV) and Office-PWV on mortality in a total of 344 hemodialysis patients. The endpoints of the study were all-cause and cardiovascular mortality. Survival analysis included Kaplan-Meier estimates and Cox regression analysis. Results: During a follow-up of 36 months, a total of 89 patients died, 35 patients due to cardiovascular cause. Kaplan-Meier estimates for tertiles of 24 h-PWV and Office-PWV were similarly associated with mortality. In univariate Cox regression analysis, 24 h-PWV and Office-PWV were equivalent predictors for all-cause and cardiovascular mortality. After adjustment for common risk factors, only 24 h-PWV remained solely predictive for all-cause mortality (hazard ratio 2.51 [95% CI 1.31–4.81]; p = 0.004). Conclusions: Comparing both measurements, 24 h-PWV is an independent predictor for all-cause-mortality in hemodialysis patients beyond Office-PWV.

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Section: Discussionmentioning

confidence: 99%

Comparison of 24-hour and Office Pulse Wave Velocity for Prediction of Mortality in Hemodialysis Patients

et al. 2019

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“…In patients with systolic HF, several hemodynamic variables have been shown to be associated with outcome, some of which easily obtainable such as systolic blood pressure 6-8 , pulse pressure 9 and resting heart rate. 8, 10 However, LVEF is the most widely used clinical indicator of LV systolic function and related risk for CV events in HF patients.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Ejection Fraction and Risk of Stroke and Cardiac Events in Heart Failure

Tullio

Qian

Thompson

et al. 2016

Stroke

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Background and Purpose In heart failure (HF), left ventricular ejection fraction (LVEF) is inversely associated with mortality and cardiovascular (CV) outcomes. Its relationship with stroke is controversial, as is the effect of antithrombotic treatment. We studied the relationship of LVEF with stroke and CV events in HF patients, and the effect of different antithrombotic treatments. Methods In the Warfarin versus Aspirin in Reduced Ejection Fraction (WARCEF) trial, 2305 patients with systolic HF (LVEF ≤ 35%) and sinus rhythm were randomized to warfarin or aspirin and followed for 3.5±1.8 years. While no differences between treatments were observed on primary outcome (death, stroke or intracerebral hemorrhage), warfarin decreased the stroke risk. The present report compares the incidence of stroke and CV events across different LVEF and treatment subgroups. Results Baseline LVEF was inversely and linearly associated with primary outcome, mortality and its components (sudden and CV death) and HF hospitalization, but not myocardial infarction. A relationship with stroke was only observed for LVEF <15% (incidence rates: 2.04 vs. 0.95/100 pt. yrs; p=0.009), which more than doubled the adjusted stroke risk (adjusted HR: 2.125, 95% CI 1.182, 3.818; p=0.012). In warfarin-treated patients, each 5% LVEF decrement significantly increased the stroke risk (adjusted HR: 1.346, 95% CI 1.044, 1.737; p=0.022; p-value for interaction=0.04). Conclusions In patients with systolic HF and sinus rhythm, LVEF is inversely associated with death and its components, whereas an association with stroke exists for very low LVEF values. An interaction with warfarin treatment on stroke risk may exist. Clinical Trial Registration - URL:http://www.clinicaltrials.gov. Unique identifier: NCT00041938

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“…1,2,4-7,10-14, 20-25 Bonapace et al 13 demonstrated that arterial stiffness is a good predictor of peak Vo2 in patients with dilated cardiomyopathy. Sakuragi et al 15 and Kaji et al 16 found a significant relationship between pro-BNP level and aortic stiffness.…”

Section: Discussionmentioning

confidence: 99%

“…Demir et al 3 assessed 98 ischemic cardiomyopathy patients with LVEF ≤35% and NYHA functional class III-IV and revealed a cut off value of 11.06 m/s for PWV as a prognostic factor and predictor of mortality in these patients. Regnault et al 14 investigated 306 patients of EPHESUS trial. They showed that PP and decreased PWV contribute to cardiovascular outcome.…”

Section: Discussionmentioning

confidence: 99%

Does aortic pulse wave velocity have any prognostic significance in advanced heart failure patients?

Dohaei¹,

Taghavi²,

Amin³

et al. 2017

J Cardiovasc Thorac Res

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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.

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Opposite Predictive Value of Pulse Pressure and Aortic Pulse Wave Velocity on Heart Failure With Reduced Left Ventricular Ejection Fraction

Cited by 84 publications

References 34 publications

Comparison of 24-hour and Office Pulse Wave Velocity for Prediction of Mortality in Hemodialysis Patients

Comparison of 24-hour and Office Pulse Wave Velocity for Prediction of Mortality in Hemodialysis Patients

Left Ventricular Ejection Fraction and Risk of Stroke and Cardiac Events in Heart Failure

Does aortic pulse wave velocity have any prognostic significance in advanced heart failure patients?

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