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Importance of Increased Arterial Resistance in Risk Prediction in Patients with Cardiovascular Risk Factors and Degenerative Aortic Stenosis
Background: Cardiovascular disease is a leading cause of heart failure (HF) and major adverse cardiac and cerebral events (MACCE). Objective: To evaluate impact of vascular resistance on HF and MACCE incidence in subjects with cardiovascular risk factors (CRF) and degenerative aortic valve stenosis...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8153260/ https://www.ncbi.nlm.nih.gov/pubmed/34068323 http://dx.doi.org/10.3390/jcm10102109 |
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author | Baran, Jakub Kleczyński, Paweł Niewiara, Łukasz Podolec, Jakub Badacz, Rafał Gackowski, Andrzej Pieniążek, Piotr Legutko, Jacek Żmudka, Krzysztof Przewłocki, Tadeusz Kabłak-Ziembicka, Anna |
author_facet | Baran, Jakub Kleczyński, Paweł Niewiara, Łukasz Podolec, Jakub Badacz, Rafał Gackowski, Andrzej Pieniążek, Piotr Legutko, Jacek Żmudka, Krzysztof Przewłocki, Tadeusz Kabłak-Ziembicka, Anna |
author_sort | Baran, Jakub |
collection | PubMed |
description | Background: Cardiovascular disease is a leading cause of heart failure (HF) and major adverse cardiac and cerebral events (MACCE). Objective: To evaluate impact of vascular resistance on HF and MACCE incidence in subjects with cardiovascular risk factors (CRF) and degenerative aortic valve stenosis (DAS). Methods: From January 2016 to December 2018, in 404 patients with cardiovascular disease, including 267 patients with moderate-to-severe DAS and 137 patients with CRF, mean values of resistive index (RI) and pulsatile index (PI) were obtained from carotid and vertebral arteries. Patients were followed-up for 2.5 years, for primary outcome of HF and MACCE episodes. Results: RI and PI values in patients with DAS compared to CRF were significantly higher, with optimal cut-offs discriminating arterial resistance of ≥0.7 for RI (sensitivity: 80.5%, specificity: 78.8%) and ≥1.3 for PI (sensitivity: 81.3%, specificity: 79.6%). Age, female gender, diabetes, and DAS were all independently associated with increased resistance. During the follow-up period, 68 (16.8%) episodes of HF-MACCE occurred. High RI (odds ratio 1.25, 95% CI 1.13–1.37) and PI (odds ratio 1.21, 95% CI 1.10–1.34) were associated with risk of HF-MACCE. Conclusions: An accurate assessment of vascular resistance may be used for HF-MACCE risk stratification in patients with DAS. |
format | Online Article Text |
id | pubmed-8153260 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-81532602021-05-27 Importance of Increased Arterial Resistance in Risk Prediction in Patients with Cardiovascular Risk Factors and Degenerative Aortic Stenosis Baran, Jakub Kleczyński, Paweł Niewiara, Łukasz Podolec, Jakub Badacz, Rafał Gackowski, Andrzej Pieniążek, Piotr Legutko, Jacek Żmudka, Krzysztof Przewłocki, Tadeusz Kabłak-Ziembicka, Anna J Clin Med Article Background: Cardiovascular disease is a leading cause of heart failure (HF) and major adverse cardiac and cerebral events (MACCE). Objective: To evaluate impact of vascular resistance on HF and MACCE incidence in subjects with cardiovascular risk factors (CRF) and degenerative aortic valve stenosis (DAS). Methods: From January 2016 to December 2018, in 404 patients with cardiovascular disease, including 267 patients with moderate-to-severe DAS and 137 patients with CRF, mean values of resistive index (RI) and pulsatile index (PI) were obtained from carotid and vertebral arteries. Patients were followed-up for 2.5 years, for primary outcome of HF and MACCE episodes. Results: RI and PI values in patients with DAS compared to CRF were significantly higher, with optimal cut-offs discriminating arterial resistance of ≥0.7 for RI (sensitivity: 80.5%, specificity: 78.8%) and ≥1.3 for PI (sensitivity: 81.3%, specificity: 79.6%). Age, female gender, diabetes, and DAS were all independently associated with increased resistance. During the follow-up period, 68 (16.8%) episodes of HF-MACCE occurred. High RI (odds ratio 1.25, 95% CI 1.13–1.37) and PI (odds ratio 1.21, 95% CI 1.10–1.34) were associated with risk of HF-MACCE. Conclusions: An accurate assessment of vascular resistance may be used for HF-MACCE risk stratification in patients with DAS. MDPI 2021-05-13 /pmc/articles/PMC8153260/ /pubmed/34068323 http://dx.doi.org/10.3390/jcm10102109 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Baran, Jakub Kleczyński, Paweł Niewiara, Łukasz Podolec, Jakub Badacz, Rafał Gackowski, Andrzej Pieniążek, Piotr Legutko, Jacek Żmudka, Krzysztof Przewłocki, Tadeusz Kabłak-Ziembicka, Anna Importance of Increased Arterial Resistance in Risk Prediction in Patients with Cardiovascular Risk Factors and Degenerative Aortic Stenosis |
title | Importance of Increased Arterial Resistance in Risk Prediction in Patients with Cardiovascular Risk Factors and Degenerative Aortic Stenosis |
title_full | Importance of Increased Arterial Resistance in Risk Prediction in Patients with Cardiovascular Risk Factors and Degenerative Aortic Stenosis |
title_fullStr | Importance of Increased Arterial Resistance in Risk Prediction in Patients with Cardiovascular Risk Factors and Degenerative Aortic Stenosis |
title_full_unstemmed | Importance of Increased Arterial Resistance in Risk Prediction in Patients with Cardiovascular Risk Factors and Degenerative Aortic Stenosis |
title_short | Importance of Increased Arterial Resistance in Risk Prediction in Patients with Cardiovascular Risk Factors and Degenerative Aortic Stenosis |
title_sort | importance of increased arterial resistance in risk prediction in patients with cardiovascular risk factors and degenerative aortic stenosis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8153260/ https://www.ncbi.nlm.nih.gov/pubmed/34068323 http://dx.doi.org/10.3390/jcm10102109 |
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