title: The prognostic value of arterial stiffness in systolic heart failure.
abstract: BACKGROUND
  Increased arterial stiffness is an indicator of mortality. This study consists of an 18-month follow-up of the mortality in advanced heart failure patients with increased arterial stiffness.
  
  
  METHODS
  The study followed up 98 patients with a diagnosis of heart failure in NYHA class III and IV (76 males, 22 females and mean age of 60 ± 12 years) with a left ventricular ejection fraction ≤ 35% as determined by the Simpson method. Augmentation index (Aix) and pulse wave propagation velocity (PWV) parameters were used as indicators of arterial stiffness. Aix and PWV values were measured by arteriography.
  
  
  RESULTS
  36 patients died. Both Aix and PWV were powerful determinants of mortality, independent of other prognostic variables (p = 0.013, OR: 0.805; p = 0.025, OR: 0.853). A cutoff value for Aix of -14.33 gave 91.2%, 80.3% sensitivity and specificity. A cutoff value for PWV of 11.06 gave 82.4%, 65.4% sensitivity and specificity mortality was predicted. Left ventricular ejection fraction (p = 0.008, OR: 0.859) and B-type natriuretic peptide (p = 0.01, OR: 0.833) was the other independent determinant of mortality. A significant difference was found in both Aix and PWV between the compensated measurements and decompensated heart failure measurements made in 70 patients (p = 0.035, p = 0.048).
  
  
  CONCLUSIONS
  Measurement of arterial stiffness is a convenient, inexpensive and reliable method for predicting mortality in patients with advanced heart failure.
authors: Department of Cardiology, Adana State Hospital, Adana, Turkey. demirkardiyoloji@hotmail.com.
authors: Serafettin
authors: S
authors: Demir
authors: Onur
authors: O
authors: Akpınar
authors: Oguz
authors: O
authors: Akkus
authors: Kamil
authors: K
authors: Nas
authors: Ilker
authors: I
authors: Unal
authors: Frenc
authors: F
authors: Molnar
authors: Ahmet
authors: A
authors: Demir
authors: Miklós
authors: M
authors: Illyés
authors: Esmeray
authors: E
authors: Acartürk
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D015150:Echocardiography, Doppler; D005260:Female; D054143:Heart Failure, Systolic / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D063177:Pulse Wave Analysis; D015203:Reproducibility of Results; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D059289:Vascular Stiffness; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain