title: Common Carotid Artery Stiffness Is Associated with Left Ventricular Structure and Function and Predicts First Hospitalization for Acute Heart Failure.
abstract: OBJECTIVE
  Proximal aortic stiffness may be more important than carotid-femoral pulse wave velocity (cf-PWV) in the pathogenesis of heart failure. The present study investigated the associations of common carotid artery (CCA) stiffness, which might be a surrogate for proximal aortic stiffness, with left ventricular (LV) structure and function, and the development of acute heart failure (AHF).
  
  
  RESULTS
  Outpatients without a history of heart failure (114 subjects aged 63.5 ± 17.5 years) were enrolled for comprehensive noninvasive cardiovascular examinations. The LV mass index, the LV ejection fraction (EF), and the ratio of the early diastolic transmitral flow velocity to the early septal mitral annular diastolic velocity (E/E') were measured by echocardiography. CCA mechanical properties, including the incremental elastic modulus (Einc), β stiffness index, CCA distensibility (CD) and circumferential strain (CS), were assessed by carotid artery ultrasonography. cf-PWV was measured by arterial tonometry. CD was significantly associated with the LV mass index, and all CCA stiffness indices were significantly associated with EF and E/E' independently of age, mean blood pressure, and cf-PWV. During a mean follow-up of 265 ± 106 days, 9 patients presented with AHF. Einc (hazard ratio 6.56, 95% confidence interval 1.64-26.26, by quartile analysis), CS (6.82, 1.70-27.35), and β stiffness index (3.91, 1.05-14.57) but not cf-PWV (1.62, 0.41-6.51) significantly predicted the events.
  
  
  CONCLUSIONS
  In patients at risk for heart failure, CCA stiffness was significantly associated with LV structure and function independently of cf-PWV. In addition, CCA stiffness but not cf-PWV predicted first AHF.
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei, Taiwan, ROC ; Cardiovascular Research Center, Taipei, Taiwan, ROC ; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Shih-Hsien
authors.initials: SH
authors.lastname: Sung
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei, Taiwan, ROC ; Cardiovascular Research Center, Taipei, Taiwan, ROC.
authors.forename: Jo-Nan
authors.initials: JN
authors.lastname: Liao
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei, Taiwan, ROC ; Cardiovascular Research Center, Taipei, Taiwan, ROC.
authors.forename: Wen-Chung
authors.initials: WC
authors.lastname: Yu
authors.affiliation: Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC ; Cardiovascular Research Center, Taipei, Taiwan, ROC.
authors.forename: Hao-Min
authors.initials: HM
authors.lastname: Cheng
authors.affiliation: Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC ; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Chen-Huan
authors.initials: CH
authors.lastname: Chen
keywords: Acute heart failure; Arterial stiffness; Common carotid artery; Left ventricular function; Speckle tracking