Dohaei Abolfazl, Taghavi Sepideh, Amin Ahmad, Rahimi Shahin, Naderi Nasim
Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
J Cardiovasc Thorac Res. 2017;9(1):35-40. doi: 10.15171/jcvtr.2017.05. Epub 2017 Mar 6.
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. 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. 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, > 0.05). In this study cardiac output (CO) (beta = -0.53, = 0.02, odds ratio = 0.6, 95% CI = 0.4-0.9), pulse pressure (PP) (beta = -0056, = 0.03, odds ratio=0.95, 95% CI = 0.89-0.99) and age (beta = -0.045, = 0.05, odds ratio = 0.96, 95% CI = 0.9-1.001) were independent predictors of composite of all-cause death/ hospitalization. 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.
通过脉搏波速度(PWV)对动脉僵硬度进行无创测量在不同亚组的心血管疾病中具有预后价值。我们旨在测量左心室射血分数(LVEF)降低的晚期心力衰竭(HF)患者的PWV,并研究其在该组患者中是否具有任何预后意义。在2013年至2015年期间,计划进行右心导管检查(RHC)的晚期HF(LVEF≤30%)诊断患者被纳入我们的研究。在导管实验室中,使用血管探测设备(Enverdis GmbH)在每位患者进行RHC之前测量PWV。随后对患者进行6个月的随访,并记录他们的住院或死亡情况(全因死亡/住院的综合情况)。总共招募了50名患者(38名男性)。年龄的平均值(标准差)为45(16)岁。平均PWV为6.8米/秒。PWV与临床、超声心动图和RHC数据之间无统计学显著相关性。有或无全因死亡/住院综合情况的患者的PWV无差异(7.3对6.3,P>0.05)。在本研究中,心输出量(CO)(β=-0.53,P=0.02,比值比=0.6,95%置信区间=0.4-0.9)、脉压(PP)(β=-0.056,P=0.03,比值比=0.95,95%置信区间=0.89-0.99)和年龄(β=-0.045,P=0.05,比值比=0.96,95%置信区间=0.9-1.001)是全因死亡/住院综合情况的独立预测因素。在晚期收缩性HF患者中,PWV可能不是一个良好的预后因素,并且相对于先前已知的预后因素没有任何附加价值。