Large artery function in patients with chronic heart failure. Studies of brachial artery diameter and hemodynamics.

Arnold, J. Malcolm O.; Marchiori, Gordon; Imrie, Jayne; Burton, Grant; Pflugfelder, P W; Kostuk, W J

doi:10.1161/01.cir.84.6.2418

Cited by 101 publications

(46 citation statements)

References 46 publications

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“…After prolonged interruption of vasodilator therapy, stiffness of muscular arteries such as the radial artery seems to increase relative to controls patients, and proportionally to the severity of systolic dysfunction; 33,34 no such difference was found without prolonged withdrawal of vasodilator treatment. 35 Therefore, the poor reproducibility of CR-PWV measurement, together with ongoing vasodilator therapy, probably explains the nonsignificant augmentation of CR-PWV in our patients with preserved EF.…”

Section: Discussionmentioning

confidence: 91%

Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure

Logeart

et al. 2005

J Hum Hypertens

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Pulse wave velocity (PWV), the carotid augmentation index (AIx), and pulse pressure (PP) may be prognostic factors in heart failure, but the possible influence of the ejection fraction (EF) and other simple haemodynamic variables on them has not been investigated in this setting. Noninvasive methods were used to measure carotid-radial (CR), carotid-femoral (CF) PWV and AIx, and brachial PP, in 135 consecutive patients with stable symptomatic chronic heart failure. The patients were divided into two groups, with preserved (X40%) or reduced (o40%) EF. CF-PWV, AIx and PP were lower in the decreased EF group (8.8572.77 versus 10.6072.75 m/s, Po0.001; 121721 versus 132724, P ¼ 0.009 and 41719 versus 67717 mmHg, Po0.001), but CR-PWV values were similar regardless of the EF status. These results were not modified after adjustment for age and sex. Multiple regression analysis showed that AIx and PP were systematically related to time domain parameters (heart rate or ejection duration) and EF, whatever the group. CF-PWV was weakly related to time domain values and unrelated to mean blood pressure (BP) or EF in the preserved EF group, whereas it was related to both mean BP and EF in the low EF group. In conclusion, whatever the EF level, PP and AIx were strongly modulated in the time domain, by pressure and by the EF level. The same relationships were found with CF-PWV, but only in the reduced EF group. Whether CF-PWV is the best prognostic factor in patients with 'diastolic' heart failure must be confirmed in a prospective study.

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Section: Discussionmentioning

confidence: 91%

Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure

Logeart

et al. 2005

J Hum Hypertens

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“…10 Moreover, a recent report indicated that the PWV increased as exercise tolerance decreased in DCM patients. 18 Furthermore, several reports point out that increased aortic stiffness is associated with LV diastolic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study showed that the PWV tended to increase in congestive HF patients as their New York Heart Association (NYHA) functional class advanced. 10 However, reports discussing the prognosis of HF using arterial stiffness measured by PWV are rare; most report on the relationship of arterial stiffness with NYHA class, exercise capacity and left ventricular (LV) function, and the indexes of arterial stiffness used in these previous publications reflect mainly the stiffness of the aorta. The brachial-ankle PWV (baPWV) reflects not only the stiffness of the aorta but also the stiffness of the total arterial tree.…”

mentioning

confidence: 99%

Elevated Arterial Stiffness Evaluated by Brachial-Ankle Pulse Wave Velocity is Deleterious for the Prognosis of Patients With Heart Failure

Meguro

Nagatomo²,

Nagae³

et al. 2009

Circ J

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Background: Arterial stiffness is used as an index of arteriosclerosis. The goal of this study was to clarify whether increased arterial stiffness, evaluated by measuring the brachial-ankle pulse wave velocity (baPWV), is a risk factor for the prognosis of heart failure (HF) patients. Methods and Results: After examination of the baPWV, as well as the levels of neurohumoral factors, the 72 enrolled HF patients were followed up for a survival study, which had a primary endpoint of re-admission because of HF. The secondary endpoint was cardiac death. Results of Cox proportional hazards modeling revealed that baPWV, systolic blood pressure (BP) and brain natriuretic peptide level were factors that affected survival (P<0.05). The patients were divided into 2 groups according to the cutoff baPWV value (1,750 cm/s). Although hemodynamic factors were similar between the groups, the high-baPWV group had a lower event-free survival rate for the primary and secondary endpoints than the low-baPWV group (P<0.05). BP at re-admission was higher in the high-baPWV group (174±30 mmHg) than in the low-baPWV group (121±33 mmHg, P<0.01). Conclusions: Elevated arterial stiffness is a risk factor for re-admission or cardiac death of HF patients. (Circ J 2009; 73: 673 -680)

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“…27 Heart failure is also associated with increased conduit vessel stiffness, possibly because of the effect of neurohumoral activation. 28 Stiffening results in increased aortic impedance and an increase in pulse wave velocity. The increase in impedance causes a larger pulsatile pressure wave for a given pulsatile flow.…”

Section: Physiological Considerationsmentioning

confidence: 99%

Isolated Systolic Hypertension

et al. 1999

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Abstract-Increased arterial stiffness results in increased characteristic impedance of the aorta and increased pulse wave velocity, which increases systolic and pulse pressures. An association between increased pulse pressure and adverse cardiovascular events has been found in normotensive and hypertensive patient populations. Increased pulse pressure has also been associated with thickening of the carotid intima and media. However, the relationship between pulse pressure and stroke has not previously been evaluated. In this study, we examined the hypothesis that pulse pressure is an independent predictor of stroke in elderly patients with systolic hypertension entered in the Systolic Hypertension in the Elderly Program. Differences in baseline characteristics were examined by tertiles of pulse pressure. The independent prognostic value of pulse pressure and mean arterial pressure for predicting either stroke or total mortality was assessed with Cox proportional hazards models that included pulse pressure, mean arterial pressure, and other variables that were significant on univariate analysis. This analysis demonstrated an 11% increase in stroke risk and a 16% increase in risk of all-cause mortality for each 10-mm Hg increase in pulse pressure. Each 10-mm Hg increase in mean arterial pressure was independently associated with a 20% increase in the risk of stroke and a 14% increase in the risk of all-cause mortality. These data provide strong evidence of an association of increased conduit vessel stiffness, as indicated by increased pulse pressure, with stroke and total mortality, independent of the effects of mean arterial pressure, in elderly patients with isolated systolic hypertension. (Hypertension. 1999;34:375-380.)

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Large artery function in patients with chronic heart failure. Studies of brachial artery diameter and hemodynamics.

Cited by 101 publications

References 46 publications

Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure

Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure

Elevated Arterial Stiffness Evaluated by Brachial-Ankle Pulse Wave Velocity is Deleterious for the Prognosis of Patients With Heart Failure

Isolated Systolic Hypertension

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