Format

Send to

Choose Destination
J Card Fail. 2019 Feb 27. pii: S1071-9164(19)30202-7. doi: 10.1016/j.cardfail.2019.02.019. [Epub ahead of print]

Pulmonary vascular resistance is associated with brachial-ankle pulse wave velocity and adverse clinical outcomes in patients with heart failure with preserved ejection fraction.

Author information

1
Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Chuo, Japan. Electronic address: takanaka@yamanashi.ac.jp.
2
Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Chuo, Japan.

Abstract

BACKGROUND:

The precise mechanisms underlying the high prevalence of pulmonary hypertension (PH) with increased pulmonary vascular resistance (PVR) in heart failure with preserved ejection fraction (HFpEF) remain largely unknown. Measurements of brachial-ankle pulse wave velocity (baPWV) have been shown to be useful for risk assessment in HF patients. Thus, this study sought to define the association of PVR with baPWV and clinical outcomes in HFpEF.

METHODS AND RESULTS:

Patients with HFpEF (n=198) had measurements of baPWV and PVR by right heart catheterization, and were prospectively followed-up for <96 months or until the occurrence of a composite of all-cause death, hospitalization with worsening HF, and non-fatal acute coronary syndrome.

RESULTS:

Multivariate logistic analysis showed that baPWV was independently associated with PH with increased PVR (p<0.001). During the follow-up period, 46 clinical events occurred. Multivariate Cox proportional hazards analysis showed that PH with increased PVR was a significant predictor of adverse outcomes after adjustment for conventional risk factors (HR 1.96, 95% CI 1.03-3.76, p=0.04).

CONCLUSIONS:

PH with increased PVR was associated with increased baPWV and adverse clinical outcomes in HFpEF. Thus, increased arterial stiffness may contribute to increased risk predictability of PVR for patients with HFpEF.

KEYWORDS:

Clinical outcomes; HFpEF; PVR; baPWV

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center