[PP.20.19] Association of Carotid Stiffness Parameters With Pulmonary Function in Patients With Systemic Sclerosis and Pulmonary Hypertension

Alanis-Sánchez, Guillermo; Rodriguez, Kevin; Ramos-Becerra, Carlos; Macías-Chumacera, Agustín; Cardona-Müller, David; Totsuka-Sutto, Sylvia Elena; Cerpa-Cruz, Sergio; Jiménez-Cázarez, Mayra B; Cardona-Muñoz, Ernesto Germán

doi:10.1097/01.hjh.0000523735.17372.a0

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“…In the literature we were able to find some observations devoted to evaluation of the pulmonary artery resistance, 11,12,[29][30][31][32] but only a few of them studied the systemic arterial stiffness. [33][34][35] Before planning this study we hypothesized the following: 1) patients with IPAH have active factors in circulation which could damage not only the pulmonary but systemic arteries too as in arterial hypertensive patients; 2) if these changes are present, they might correlate with other parameters influencing on the prognosis. That is why we evaluated systemic arterial stiffness measured as carotid-femoral pulse wave velocity (PWVe), carotid-radial PWV (PWVm) and cardio-ankle vascular index (CAVI) in IPAH patients and compared the results with those in the matched arterial hypertensive patients and the healthy people.…”

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confidence: 99%

<p>Systemic Arterial Stiffness in New Diagnosed Idiopathic Pulmonary Arterial Hypertension Patients</p>

Radchenko

Zhyvylo

Titov

et al. 2020

VHRM

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Objective: We suggested: 1) patients with idiopathic pulmonary hypertension (IPAH) have active factors which could damage not only the pulmonary but systemic arteries too as in arterial hypertensive patients; 2) if these changes were present, they might correlate with other parameters influencing on the prognosis. This study is the first attempt to use cardioankle vascular index (CAVI) for the evaluation of systemic arterial stiffness in patients with IPAH. Methods: A total of 112 patients were included in the study: group 1 consisted of 45 patients with new diagnosed IPAH, group 2 included 32 patients with arterial hypertension, and in the control group were 35 healthy persons adjusted by age. Right heart catheterization, ECG, a 6-minute walk test (6MWT), echocardiography, blood pressure (BP) measurement and ambulatory BP monitoring, pulse wave elastic artery stiffness (PWVe; segment carotid-femoral arteries) and muscular artery stiffness (PWVm; segment carotid-radial arteries), CAVI, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) level were provided. The Spearman correlation, a linear regression and multivariable binary logistic analysis were performed to indicate the predictors associated with PWV and CAVI. Results: The groups were adjusted for principal characteristics influenced on arterial stiffness. IPAH patients had significantly (P<0.001 for all) shorter 6MWT distance and higher Borg dyspnea score than the patients with arterial hypertension (systolic/diastolic BP = 146.1 ±10.7/94.2±9.8 mmHg) and the control group = 330.2±14.6 vs 523.8±35.3 and 560.9±30.2 m respectively and 6.2±1.8 vs 1.2±2.1 and 0.9±2.8 points. The PWVm and PWVe were the highest in hypertensive patients (10.3±1.5 and 11.42±1.70 m/s). The control group and IPAH did not have significant differences in aorta BP, but PWVm/PWVe values were significantly (P<0.003/0.008) higher in IPAH patients than in the control group (8.1±1.9/8.49±1.92 vs 6.63±1.34/7.29±0.87 m/s). The CAVIs on both sides were significantly lower in the healthy subjects (5.91±0.99/5.98±0.87 right/left side). Patients with IPAH did not differ from the arterial hypertension patients by CAVIs in comparison with the control group (7.40±1.32/ 7.22±1.32 vs 7.19±0.78/7.2±1.1 PWVe) did not correlate with any parameters except uric acid. PWVm correlated with uric acid (r=0.58, P<0.001), NT-proBNP (r=0.33, P=0.03) and male gender (r=0.37, P=0.013) at Spearman analysis, but not at multifactorial linear regression analysis. The CAVI correlated with age and parameters characterized functional capacity (6MWT distance) and right ventricle function (NT-proBNP, TAPSE) at Spearman analysis and with age and TAPSE at multifactorial linear regression analysis. At binary logistic regression analysis CAVI > 8.0 at right and/or left side had a correlation with age, 6MWT distance, TAPSE, but an independent correlation was only with age (β=1.104, P=0.008, CI 1.026-1.189) and TAPSE (β=0.66, P=0.016, CI 0.474-0.925). Conclusion: In spite of equal and at normal range BP level, the age-adjuste...

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