2011


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2011/

Risk factors of cardiovascular complications in patients with chronic heart failure: focus on arterial stiffness

Kosheleva N. A., Rebrov A. P.

Keywords: arterial stiffness, prognosis, CHF

DOI: 10.18087 / rhfj.2011.3.1509

Background. Evaluation of prognosis in patients with CHF is one of the most important clinical problems. Rigidly of main arteries in patients with CHF is not studied enough. Objective. To assess the role of arterial stiffness in development of cardiovascular complications (CVC) in patients with CHF. Materials and methods. The study included 207 patients with CHF and 55 healthy individuals. Inclusion criteria: symptomatic heart failure, developed after Q-wave myocardial infarction, signed informed consent. Pulse wav analysis was performed with program «Tensiomed», «TensioClinic» arteriography (Hungary). Results. The average age was 55.3±6.4 years, 90 % were men. During one year 68 cases of CVC were registered: 45 cases of CHF deterioration, 18 cases of unstable angina, 11 – recurrent MI and 17 deaths. Significant correlation was revealed between pulse wave velocity in aorta (PWVA) and age, systolic and diastolic blood pressure, thickness of ventricular septum, LV posterior wall thickness, LV myocardial mass index, end-systolic left atrial size, mean pressure in pulmonary artery, NT-proBNP level, CHF FC. Survival curves were compared using Kaplan-Meier method, that revealed, that patients with PWVA >12 m / s had significantly higher risk of decompensated heart failure (p=0.001), recurrent MI (p=0.01), death (p=0.001) and CVC in total (p=0.01) than patients with PWVA ≤12 m / sec. Relative risk of CVC during one year was twice higher for patients with higher PWVA (RR 2.02, 95 % CI 1.01–4.03). BMI, heart rate, left ventricular ejection fraction and SPVA were independent predictors of CVC in a multivariate model. PWVA as a marker of stiffness is a predictor of CVC regardless of age and classic FR.
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Kosheleva N. A., Rebrov A. P. Risk factors of cardiovascular complications in patients with chronic heart failure: focus on arterial stiffness. Russian Heart Failure Journal. 2011;12(3):136-141

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