Clinical InvestigationHeart FailureIncreased Aortic Pulse Wave Velocity as Measured by Echocardiography Is Strongly Associated with Poor Prognosis in Patients with Heart Failure
Section snippets
Patients
We prospectively studied a sample of 156 outpatients (129 men; mean age, 65 years) with diagnosed HF, who regularly attended the HF clinic of the cardiology division at the University Hospital of Verona. Each patient had a diagnosis of HF, which was based on the presence of LV systolic dysfunction (i.e., LV ejection fraction < 45% and end-diastolic LV volume > 90 mL/m2). Inclusion criteria of the study were stable clinical conditions for at least 6 months and the presence of optimal medical
Results
During a follow-up period of 5 years (mean [SD] follow-up period of 36 ± 19 months), there were 20 cardiac deaths and 15 hospitalizations for worsening HF. Three patients received nonurgent cardiac transplantation, and, accordingly, they were censored as alive at the date of surgery. No patients died from noncardiac causes during the follow-up period. The baseline characteristics of patients with HF grouped according to the occurrence of any clinical events at follow-up are summarized in Table 1
Discussion
To our knowledge, this prospective, observational study is the first to specifically address the value of aortic PWV in predicting adverse clinical outcomes in patients with HF. The major finding of this “real-world” study is that increased aortic PWV, as measured by conventional echocardiography, was strongly associated with an increased risk of cardiac death and hospitalization (combined end point) in a sample of outpatients with HF who were followed up for a period of 5 years. Interestingly,
Conclusions
The results of this study provide the first evidence, to our knowledge, that echocardiographically derived aortic PWV is a strong predictor of adverse clinical outcomes (cardiac death or hospitalization) in patients with systolic HF. Aortic PWV allows us also to identify a subgroup of patients with HF and with more distensible aortas who bear a better prognosis, which suggests that more preserved large elastic artery properties could play a role in slowing the progression of HF also in those
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