Artery Research

Volume 16, Issue C, December 2016, Pages 55 - 55

4.5 U-SHAPED RELATIONSHIP OF RESERVOIR PRESSURE TO CARDIOVASCULAR EVENTS IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION

Authors
Stephanie Parragh1, Bernhard Hametner1, Christopher Mayer1, Siegfried Wassertheurer1, Thomas Weber2
1AIT Austrian Institute of Technology GmbH, Health & Environment Department, Biomedical Systems, Vienna, Austria
2Vienna University of Technology, Institute of Analysis and Scientific Computing, Vienna, Austria
Available Online 24 November 2016.
DOI
10.1016/j.artres.2016.10.024How to use a DOI?
Abstract

Objectives: Parameters of aortic stiffness are considered important indicators of cardiovascular risk. However, in heart failure with reduced ejection fraction (HFrEF), their association to outcome was found to be inversed. The aim of this work was to analyze the relationship of the amplitude of reservoir pressure (PresAmp) to cardiovascular events in HFrEF.

Methods: Patients with HFrEF were collected from a cohort undergoing coronary angiography at the hospital Wels-Grieskirchen, Austria. PresAmp was computed from central pressure obtained from radial readings by a generalized transfer function. A combination of myocardial infarction, death, stroke and cardiovascular revascularization served as primary endpoint. Cox-regression analysis and Kaplan-Meier estimates were used for survival analysis.

Results: 83 (9 female) patients were included with a mean age of 61 years. During a median follow-up of 1272 days, 30 patients suffered from the combined endpoint. No significant linear association to outcome was found for PresAmp, brachial or central pulse pressure in Cox-analysis. In all three cases, Kaplan-Meier analysis comparing the respective quartiles indicated a nonlinear, U-shaped relation, but only for PresAmp the increase in risk was significant (P<0.05) in both directions. Although patients with low (16.6 (2.8 SD) mmHg) and high (26.1 (3.2 SD) mmHg) PresAmp showed similar risk, they differed in blood pressure, age, presence of hypertension, presence of coronary artery disease, ventricular dimensions, ejection fraction and diastolic function (table).

Conclusion: We found a U-shaped relation of reservoir pressure to outcome in our population. Pulsatile hemodynamics seem to separate patients with HFrEF into different phenotypes with different prognosis.

Parameter 1st quartile PresAmp 4th quartile PresAmp P-value
N patients 21 (19m/2f) 21 (19m/2f)
Age, years 57.1 (9.68 SD) 69.4 (9.24 SD) <0.001
Hypertension 6 (29 %) 19 (90 %) <0.001
Coronary artery disease 8 (38 %) 14 (67 %) 0.06
Brachial PP, mmHg 31.0 (6.87 SD) 63.0 (8.32 SD) <0.001
Central PP, mmHg 20.4 (4.08 SD) 48.6 (9.33 SD) <0.001
E/E’medial 30.8 (15.8 SD) 19.3 (10.0 SD) 0.008
EF, % 22.5 (7.33 SD) 31.6 (7.49 SD) <0.001
LVEDV, ml 253 (91.3 SD) 162 (64.5 SD) <0.001
LVESV, ml 199 (75.8 SD) 112 (50.8 SD) <0.001
Table:

Comparison of patients with low (1st quartile) and high (4th quartile) PresAmp. PP, pulse pressure. EF, ejection fraction. LVEDV, left ventricular end-diastolic volume. LVESV, left ventricular end-systolic volume. Values are presented as mean (standard deviation).

Open Access
This is an open access article distributed under the CC BY-NC license.

Journal
Artery Research
Volume-Issue
16 - C
Pages
55 - 55
Publication Date
2016/11/24
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2016.10.024How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - Stephanie Parragh
AU  - Bernhard Hametner
AU  - Christopher Mayer
AU  - Siegfried Wassertheurer
AU  - Thomas Weber
PY  - 2016
DA  - 2016/11/24
TI  - 4.5 U-SHAPED RELATIONSHIP OF RESERVOIR PRESSURE TO CARDIOVASCULAR EVENTS IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION
JO  - Artery Research
SP  - 55
EP  - 55
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.10.024
DO  - 10.1016/j.artres.2016.10.024
ID  - Parragh2016
ER  -