PMID- 32888111
OWN - NLM
STAT- MEDLINE
DCOM- 20210915
LR  - 20210915
IS  - 1970-9366 (Electronic)
IS  - 1828-0447 (Linking)
VI  - 16
IP  - 3
DP  - 2021 Apr
TI  - New indices of arterial stiffness correlate with disease severity and mid-term 
      prognosis in acute decompensated heart failure.
PG  - 661-668
LID - 10.1007/s11739-020-02486-x [doi]
AB  - Arterial stiffness has been implicated in pathophysiology of heart failure (HF) 
      since it is involved in the ventricular-vascular coupling. Recently, new indices 
      obtained by a cuff oscillometric technique, the arterial velocity pulse index 
      (AVI) for the stiffness of central arteries and the arterial pressure volume 
      index (API) for the stiffness of peripheral arteries have been developed and 
      validated. However, the AVI and API measurement has not been attempted in HF 
      population. This study aimed to investigate the relationship between the AVI, API 
      and clinical parameters and outcomes in HF patients. A prospective cohort of 
      patients with acute decompensated HF were enrolled within 6 months, who were 
      admitted to a tertiary referral hospital in China. Measurement of the AVI and API 
      (AVE-1500, Shisei Datum, Tokyo, Japan) was performed on the day of admission and 
      discharge. Patients were followed up to 6 months for the composite endpoint of 
      all-cause death and rehospitalization for HF. A total of 127 patients were 
      recruited for analysis (60 +/- 15 years, 70% male). 80% of the patients were in New 
      York Heart Association (NYHA) Class III or IV at admission with mean left 
      ventricular ejection fraction (LVEF) of 34 +/- 9%. During hospitalization, all 
      patients received guideline-directed medical therapy if not contraindicated. The 
      AVI (27.3 +/- 5.0 vs. 28.6 +/- 6.7, P = 0.002) and API (24.9 +/- 4.9 vs. 26.0 +/- 6.5, 
      P = 0.05) were lower at discharge than at admission. By dividing the patients 
      into mild to severe group based on systolic blood pressure (SBP) and LVEF or into 
      tertiles according to the amino-terminal pro-brain natriuretic peptide 
      (NT-proBNP), transmitral E velocity over mitral annular e' velocity (E/e' ratio), 
      it was observed that the AVI increased with a higher level of NT-proBNP (P for 
      trend < 0.001), a larger E/e' (P for trend < 0.001) and a lower LVEF (P for 
      trend = 0.0183), while the API increased as the E/e' and systolic blood pressure 
      became higher (both P for trend < 0.05). The improvement in AVI at discharge was 
      correlated with LVEF (R = - 0.3024, P < 0.05) and NT-proBNP improvement 
      (R = 0.3118, P < 0.05), while the change in API was positively correlated with 
      SBP change (R = 0.3897, P < 0.001). In 6 months after discharge, there were 52 
      predefined events including 15 deaths and 44 rehospitalization for HF. Apart from 
      the level of NT-proBNP, the AVI at discharge of >/= 26 showed a trend of being 
      associated with the composite outcome (HR 2.747, 95% CI 1.411-5.349, P < 0.001 
      for univariate analysis; HR 1.864, 95% CI 0.892-3.893, P = 0.09761 for 
      multivariate analysis). New noninvasive arterial stiffness indices as the AVI and 
      API reflected severity of illness and midterm prognosis in admitted HF patients. 
      Further studies are warranted for understanding its mechanisms and developing 
      clinical applications.
FAU - Zhou, Junteng
AU  - Zhou J
AD  - Department of Cardiology, West China Hospital, Sichuan University, No. 37 Guoxue 
      Alley, Chengdu, 610041, China.
FAU - Wang, Yushu
AU  - Wang Y
AD  - Department of Cardiology, Chengdu First People's Hospital, No. 18 North Wanxiang 
      Road, Chengdu, 610041, China.
FAU - Feng, Yizhou
AU  - Feng Y
AD  - Department of Cardiology, West China Hospital, Sichuan University, No. 37 Guoxue 
      Alley, Chengdu, 610041, China.
FAU - Chen, Xiaojing
AU  - Chen X
AD  - Department of Cardiology, West China Hospital, Sichuan University, No. 37 Guoxue 
      Alley, Chengdu, 610041, China.
FAU - Zhang, Qing
AU  - Zhang Q
AD  - Department of Cardiology, West China Hospital, Sichuan University, No. 37 Guoxue 
      Alley, Chengdu, 610041, China. qzhang2000cn@163.com.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20200904
PL  - Italy
TA  - Intern Emerg Med
JT  - Internal and emergency medicine
JID - 101263418
RN  - 0 (Biomarkers)
SB  - IM
MH  - Acute Disease
MH  - Biomarkers/blood
MH  - Brachial Artery/physiopathology
MH  - China
MH  - Female
MH  - Heart Failure/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prospective Studies
MH  - *Pulse Wave Analysis
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - *Vascular Stiffness
OTO - NOTNLM
OT  - Arterial pressure volume index
OT  - Arterial pulse velocity index
OT  - Arterial stiffness
OT  - Heart failure
EDAT- 2020/09/06 06:00
MHDA- 2021/09/16 06:00
CRDT- 2020/09/05 05:20
PHST- 2020/06/14 00:00 [received]
PHST- 2020/08/21 00:00 [accepted]
PHST- 2020/09/06 06:00 [pubmed]
PHST- 2021/09/16 06:00 [medline]
PHST- 2020/09/05 05:20 [entrez]
AID - 10.1007/s11739-020-02486-x [pii]
AID - 10.1007/s11739-020-02486-x [doi]
PST - ppublish
SO  - Intern Emerg Med. 2021 Apr;16(3):661-668. doi: 10.1007/s11739-020-02486-x. Epub 
      2020 Sep 4.