Improvement of arterial stiffness in the transition from acute decompensated heart failure to chronic compensated heart failure

Clin Cardiol. 2013 Jun;36(6):358-62. doi: 10.1002/clc.22127. Epub 2013 Apr 12.

Abstract

Background: Pulse wave velocity (PWV) is a well-established marker for aortic stiffness and may be a prognostic factor in heart failure (HF). This study investigates whether PWV changes as patients transition from acute decompensated heart failure (ADHF) to chronic compensated heart failure (CCHF).

Hypothesis: Arterial stiffness is related with the development of HF.

Methods: Regional PWV was prospectively measured using noninvasive applanation tonometry in consecutive ADHF patients (n = 55). PWV measurements of 45 patients were taken at admission and 3-month follow-up (F/U).

Results: Central and upper-extremity PWV, but not lower-extremity PWVs, were found to have improved after 3 months compared with the admission PWV (central: 8.73 ± 1.17 vs 8.39 ± 0.99 m/s, P = 0.018; upper extremity: 8.59 ± 0.84 vs 8.33 ± 0.82 m/s, P = 0.028). Multivariate logistic regression analyses revealed that low-density lipoprotein cholesterol was significantly associated with the change of PWV in HF (odds ratio: 1.037, 95% confidence interval: 1.003-1.071, P = 0.030). In preserved left ventricular ejection fraction patients (n = 26) and ischemic patients (n = 31), central and upper-extremity PWVs improved over the admission PWV at 3-month F/U.

Conclusions: The present results indicate that central and upper-extremity PWVs, but not lower-extremity PWV, are increased in ADHF and improve as patients transition from ADHF to CCHF.

MeSH terms

  • Acute Disease
  • Aged
  • Chi-Square Distribution
  • Chronic Disease
  • Disease Progression
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / physiopathology*
  • Heart Failure / therapy
  • Humans
  • Logistic Models
  • Lower Extremity / blood supply*
  • Male
  • Manometry
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Prospective Studies
  • Pulse Wave Analysis
  • Stroke Volume
  • Time Factors
  • Upper Extremity / blood supply*
  • Vascular Stiffness*
  • Ventricular Function, Left