Abstract 13238: Association of Worsening Arterial Stiffness With the Progression of Stage A/B Heart Failure
Introduction: Several studies have suggested that an enhanced and deteriorating arterial stiffness is associated with an increase in left ventricular (LV) afterload and LV diastolic dysfunction, which may contribute to heart failure (HF) progression. We sought to investigate the independent and incremental role of worsening arterial stiffness in new-onset HF in patients with preclinical HF.
Methods: We retrospectively studied 456 consecutive asymptomatic patients with HF risk factors (hypertension, obesity, type 2 diabetes mellitus, atrial fibrillation, and ischemic heart disease) who underwent paired applanation tonometry examinations (median interval of 2.4 years) during 2006-2011. Brachial ankle pulse wave velocity (baPWV) was measured as a surrogate marker of arterial stiffness. Patients were followed up for admission for new-onset HF over a median duration of 4.9 years after the second examination.
Results: HF was observed in 30 patients (7%). The change in baPWV (ΔbaPWV) was significantly associated with hospitalization for new-onset HF, independent of and incremental to comorbidities, renal dysfunction, left ventricular (LV) dysfunction, and baPWV at baseline (Per 10% increase, Hazard ratio, 1.23-1.42). Even in patients with an LV ejection fraction of ≥40%, ΔbaPWV was significantly associated with the primary outcome after similar adjustments. When the patients were divided into groups based on the optimal cutoff value of ≥15% ΔbaPWV and the generally accepted external cutoff value of ≥1750 cm/s for baseline baPWV, the Kaplan-Meier estimates of the time of hospitalization for new-onset HF showed that a higher rate of HF was associated with higher baPWV at baseline and higher ΔbaPWV (Figure).
Conclusions: In patients with stage A/B HF, the deterioration of arterial stiffness was associated with hospitalization for new-onset HF, independent of and incremental with the clinical LV function and increased stiffness parameters at baseline.
Author Disclosures: H. Aisu: None. M. Saito: None. S. Inaba: None. T. Morofuji: None. K. Takahashi: None. T. Sumimoto: None. T. Okura: None. J. Higaki: None.
- © 2016 by American Heart Association, Inc.