title: Association of aortic stiffness with biomarkers of myocardial wall stress after myocardial infarction.
abstract: BACKGROUND
  Aortic pulse wave velocity (PWV) was linked to LV-geometry and -function in patients with kidney disease and non-ischemic cardiomyopathy. The role of aortic compliance after acute STEMI is so far unknown. In the present study, we prospectively investigated the relationship of increased aortic stiffness with biomarkers of myocardial wall stress 4 months after STEMI.
  
  
  METHODS
  48 STEMI patients who were reperfused by primary coronary angioplasty underwent cardiovascular magnetic resonance (CMR) at baseline and at 4-month follow-up. The CMR protocol comprised cine-CMR as well as gadolinium contrast-enhanced CMR. Aortic PWV was determined by velocity-encoded, phase-contrast CMR. Blood samples were routinely drawn at baseline and follow-up to determine N-terminal pro-B-type natriuretic peptide (NT-proBNP). In a subgroup of patients, mid-regional pro-adrenomedullin (MR-proADM) and mid-regional pro-A-type natriuretic peptide (MR-proANP) levels were determined.
  
  
  RESULTS
  Patients with a PWV above median (>7.0m/s) had significantly higher NT-proBNP, MR-proADM and MR-proANP concentrations at 4-month follow-up than patients with a PWV below median (all p<0.02). PWV showed moderate to good correlation with NT-proBNP, MR-proAMD and MR-proANP levels 4 months after STEMI (all p<0.05). Multivariate analysis revealed PWV, beside myocardial infarct size, as an independent predictor of 4-month NT-proBNP levels after correction for age, creatinine and LV ejection fraction (model r: 0.781, p<0.001).
  
  
  CONCLUSIONS
  Aortic stiffness is directly associated with biomarkers of myocardial wall stress 4 months after reperfused STEMI, suggesting a role for aortic stiffness in chronic LV-remodelling.
authors.affiliation: University Clinic of Internal Medicine III, Cardiology, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Klug
authors.affiliation: University Clinic of Internal Medicine III, Cardiology, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: H J
authors.initials: HJ
authors.lastname: Feistritzer
authors.affiliation: University Clinic of Internal Medicine III, Cardiology, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: S J
authors.initials: SJ
authors.lastname: Reinstadler
authors.affiliation: University Clinic of Internal Medicine III, Cardiology, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: L
authors.initials: L
authors.lastname: Krauter
authors.affiliation: Department of Radiology I, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Mayr
authors.affiliation: University Clinic of Internal Medicine III, Cardiology, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Mair
authors.affiliation: Central Institute for Medical Laboratory Diagnostics, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Hammerer-Lercher
authors.affiliation: Department of Radiology I, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Kremser
authors.affiliation: Department of Radiology I, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Schocke
authors.affiliation: University Clinic of Internal Medicine III, Cardiology, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. Electronic address: Bernhard.Metzler@uki.at.
authors.forename: B
authors.initials: B
authors.lastname: Metzler
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001018:Aortic Diseases / Q000453:epidemiology* / Q000378:metabolism*; D009320:Atrial Natriuretic Factor / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology / Q000378:metabolism / Q000628:therapy; D009206:Myocardium / Q000378:metabolism*; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D011673:Pulsatile Flow; D012307:Risk Factors; D013314:Stress, Mechanical; D013318:Stroke Volume; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C552580:midregional pro-atrial natriuretic peptide, human; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D003404:Creatinine
keywords: Aortic stiffness; Cardiovascular magnetic resonance; Mid-regional pro-A-type natriuretic peptide; Mid-regional pro-adrenomedullin; Myocardial infarction; Pulse wave velocity