Abstract 12736: Increased Arterial Stiffness Predicts Cardiovascular Events in Patients with Heart Failure with Reduced Left Ventricular Ejection Fraction
Background: Impaired arterial stiffness reflects intrinsic stiffness of the aortic wall, attributed to it being the earliest detectable manifestations of adverse structural and functional damages within the vessel wall. Cardio-ankle vascular index (CAVI) provides noninvasive, objective information on arterial stiffness, independent of blood pressure. This study aimed to examine the prognostic importance of arterial stiffness assessed by CAVI on long-term cardiovascular (CV) morbidity and mortality in patients with chronic heart failure (HF).
Methods and Results: This study consists of 134 patients with chronic HF who were hemodynamically stable, and decreased exercise tolerance, a left ventricular ejection fraction (LV EF) of less than 50%, and optimal medical treatment for HF. Patients had CAVI examination to measure arterial stiffness, and were followed for more than 1 year or until the occurrence of cardiovascular death or cardiovascular hospitalization. Impaired CAVI was defined as > the mean plus 1 SD of the age- and gender-specific normal CAVI values, according to the results in 5,188 healthy subjects. Fifty five (41%) patients had increased CAVI. During follow-up periods (3.0±1.5 years), 20 (14.9%) patients had primary endpoint (5 CV death and 15 CV hospitalization). Patients with CV event had lower LV EF (p=0.04), larger left atrium volume (p≤0.01), higher E/e’ (p=0.04), and increased CAVI (p≤0.01) than those without CV event. Multivariable analysis indicated that increased CAVI was an independent factor associated with CV event (p=0.03).
Conclusions: This study demonstrated that impaired arterial stiffness assessed by CAVI predicted future CV outcomes in patients with chronic HF with reduced LV EF.
- © 2013 by American Heart Association, Inc.