Feola Mauro, Testa Marzia, Ferreri Cinzia, Rosso GianLuca, Rossi Arianna, Ruocco Gaetano
Ospedale Regina Montis Regalis, Cardiology Department, Mondovì, 12084 Cuneo, Italy.
University of Geriatrics, 10121 Turin, Italy.
J Clin Med. 2019 Oct 18;8(10):1721. doi: 10.3390/jcm8101721.
The arterial stiffness in the pathogenesis and clinical outcome in heart failure (HF) patients still needs to be clarified. An increased pulse wave velocity (PWV) in HF patients in comparison with healthy subjects and cardiovascular risk factors (CVRF) patients has been demonstrated. The aim of this study was to evaluate the arterial stiffness in HF patients in comparison to control populations.
Consecutive patients admitted for decompensated heart failure underwent echocardiogram and evaluation of arterial stiffness by measuring the PWV and the augmentation index (AIx75). The arterial stiffness was also calculated in a control group formed by healthy volunteers and in CVRF subjects.
Fifty-nine HF patients (62% males; age 75 years) with mean left ventricular ejection fraction (LVEF) 38% and N-terminal pro B-type natriuretic peptide (NT-proBNP) (8111 pg/mL) entered the study. The HF population were compared with 22 healthy controls (age 58 years) and 20 CVRF patients (age 72 years). The analysis of PWV demonstrated a velocity of 10.6 m/s (9-12.1 m/s), 11.7 m/second (10.4-12.8 m/s), and 10.1 m/second (8.6-10.8m/s) in controls, CVRF, and HF patients ( = 0.01). AIx75 was seen to be higher in the CVRF group vs. HF patients (34% vs. 22%, = 0.001). In HF patients PWV was inversely correlated with the glomerular filtration rate ( = -0.40; = 0.002) and directly with central systolic pressure (SP) ( = 0.29; = 0.02), brachial SP ( = 0.33; = 0.01) as well as AIx75 correlated with GFR ( = -033; = 0.01).
PWV proved to be different in HF patients in comparison with CVRF/healthy population. The strongest correlation was revealed between the values of PWV/AIx75 and renal function.
心力衰竭(HF)患者发病机制及临床预后中的动脉僵硬度仍有待阐明。与健康受试者及心血管危险因素(CVRF)患者相比,HF患者的脉搏波速度(PWV)已被证实有所增加。本研究的目的是评估HF患者与对照组人群相比的动脉僵硬度。
连续收治的失代偿性心力衰竭患者接受了超声心动图检查,并通过测量PWV和增强指数(AIx75)评估动脉僵硬度。还在由健康志愿者组成的对照组和CVRF受试者中计算了动脉僵硬度。
59例HF患者(男性占62%;年龄75岁),平均左心室射血分数(LVEF)为38%,N末端B型利钠肽原(NT-proBNP)为(8111 pg/mL)进入研究。将HF人群与22名健康对照者(年龄58岁)和20名CVRF患者(年龄72岁)进行比较。PWV分析显示,对照组、CVRF组和HF患者的速度分别为10.6 m/s(9 - 12.1 m/s)、11.7 m/秒(10.4 - 12.8 m/s)和10.1 m/秒(8.6 - 10.8m/s)(P = 0.01)。CVRF组的AIx75高于HF患者(34%对22%,P = 0.001)。在HF患者中,PWV与肾小球滤过率呈负相关(r = -0.40;P = 0.002),与中心收缩压(SP)呈正相关(r = 0.29;P = 0.02),与肱动脉SP呈正相关(r = 0.33;P = 0.01),并且AIx75与肾小球滤过率相关(r = -0.33;P = 0.01)。
与CVRF/健康人群相比,HF患者的PWV被证明有所不同。PWV/AIx75值与肾功能之间显示出最强的相关性。