Prognostic Significance of Systemic Arterial Stiffness Evaluated by Cardio-Ankle Vascular Index in Patients with Idiopathic Pulmonary Hypertension
Received 2 December 2020
Accepted for publication 27 January 2021
Published 9 March 2021 Volume 2021:17 Pages 77—93
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Konstantinos Tziomalos
Ganna D Radchenko, Yuriy M Sirenko
Department of Symptomatic Hypertension, “National Scientific Center “The M.D. Strazhesko Institute of Cardiology”” of National Academy of Medical Science, Kyiv, Ukraine
Correspondence: Ganna D Radchenko
Department of Symptomatic Hypertension, “National Scientific Center “The M.D. Strazhesko Institute of Cardiology”” of National Academy of Medical Science, 5, Narodnogo Opolchenia Str, Kyiv, 03680, Ukraine
Tel +380 667128405
Email [email protected]
Background: In a previous study, the cardio-ankle vascular index (CAVI) was increased significantly in idiopathic pulmonary arterial hypertension (IPAH) patients compared to the healthy group and did not much differ from one in systemic hypertensives. In this study the relations between survival and CAVI was evaluated in patients with IPAH.
Patients and Methods: We included 89 patients with new-diagnosed IPAH without concomitant diseases. Standard examinations, including right heart catheterization (RHC) and systemic arterial stiffness evaluation, were performed. All patients were divided according to CAVI value: the group with CAVI ≥ 8 (n = 18) and the group with CAVI < 8 (n = 71). The mean follow-up was 33.8 ± 23.7 months. Kaplan–Meier and Cox regression analysis were performed for the evaluation of our cohort survival and the predictors of death.
Results: The group with CAVI≥ 8 was older and more severe compared to the group with CAVI< 8. Patients with CAVI≥ 8 had significantly reduced end-diastolic (73.79± 18.94 vs 87.35± 16.69 mL, P< 0.009) and end-systolic (25.71± 9.56 vs 33.55± 10.33 mL, P< 0.01) volumes of the left ventricle, the higher right ventricle thickness (0.77± 0.12 vs 0.62± 0.20 mm, P < 0.006), and the lower TAPSE (13.38± 2.15 vs 15.98± 4.4 mm, P< 0.018). RHC data did not differ significantly between groups, except the higher level of the right atrial pressure in patients with CAVI≥ 8– 11.38± 7.1 vs 8.76± 4.7 mmHg, P< 0.08. The estimated overall survival rate was 61.2%. The CAVI≥ 8 increased the risk of mortality 2.34 times (CI 1.04– 5.28, P = 0.041). The estimated Kaplan–Meier survival in the patients with CAVI ≥ 8 was only 46.7 ± 7.18% compared to patients with CAVI < 8 - 65.6 ± 4.2%, P = 0.035. At multifactorial regression analysis, the CAVI reduced but saved its relevance as death predictor - OR = 1.13, CI 1.001– 1.871.
Summary: We suggested the CAVI could be a new independent predictor of death in the IPAH population and could be used to better risk stratify this patient population if CAVI is validated as a marker in a larger multicenter trial.
Keywords: idiopathic pulmonary arterial hypertension, systemic arterial stiffness, pulse wave velocity, cardio-ankle vascular index, survival
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]