title: Association of worsening arterial stiffness with incident heart failure in asymptomatic patients with cardiovascular risk factors.
abstract: We investigated the independent and incremental role of worsening arterial stiffness in new-onset heart failure (HF) in patients with preclinical HF. We retrospectively studied 456 consecutive asymptomatic patients with HF risk factors (hypertension, obesity, type 2 diabetes mellitus, atrial fibrillation and ischemic heart disease) who underwent paired applanation tonometry examinations (median interval of 2.4 years) during 2006-2011. Brachial ankle pulse wave velocity (baPWV) was measured as a surrogate marker of arterial stiffness. Patients were followed up for admission for new-onset HF over a median duration of 4.9 years after the second examination. HF was observed in 30 patients (7%). The change in baPWV (∆baPWV) was significantly associated with hospitalization for new-onset HF, independent of and incremental to comorbidities, renal dysfunction, left ventricular (LV) dysfunction and baPWV at baseline. Even in patients with an LV ejection fraction of ⩾40%, ∆baPWV was significantly associated with hospitalization for new-onset HF after similar adjustments. When the patients were divided into groups based on this cutoff value of ⩾15% ∆baPWV and the generally accepted external cutoff value of ⩾1750 cm s-1for baseline baPWV, the Kaplan-Meier estimates of the time of hospitalization for new-onset HF showed that a higher rate of HF was associated with higher baPWV at baseline and higher ∆baPWV (P=0.00005). In asymptomatic patients with cardiovascular risk factors, the deterioration in arterial stiffness was associated with hospitalization for new-onset HF, independent of and incremental with the clinical LV function and increased stiffness parameters at baseline.
authors: Department of Cardiology, Kitaishikai Hospital, Ozu, Japan.|Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Japan.
authors: Hiroe
authors: H
authors: Aisu
authors: Department of Cardiology, Kitaishikai Hospital, Ozu, Japan.
authors: Makoto
authors: M
authors: Saito
authors: Department of Cardiology, Kitaishikai Hospital, Ozu, Japan.
authors: Shinji
authors: S
authors: Inaba
authors: Department of Cardiology, Kitaishikai Hospital, Ozu, Japan.
authors: Toru
authors: T
authors: Morofuji
authors: Department of Cardiology, Kitaishikai Hospital, Ozu, Japan.|Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Japan.
authors: Kayo
authors: K
authors: Takahashi
authors: Department of Cardiology, Kitaishikai Hospital, Ozu, Japan.
authors: Takumi
authors: T
authors: Sumimoto
authors: Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Japan.
authors: Takafumi
authors: T
authors: Okura
authors: Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Japan.
authors: Jitsuo
authors: J
authors: Higaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D059289:Vascular Stiffness / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*