Key result
High pulse wave velocity measured by cardiac MRI (HR 1.31; 95% CI 1.1-1.7) or oscillometric methods (HR 1.24; 95% CI 1.0-1.5) significantly predicted major adverse cardiovascular events over 6 years.
Why the study?
Pulse wave velocity (PWV) predicts MACE after MI, but technical approaches yield significantly different values, prompting evaluation of cut-off values for CMR and oscillometric methods.
Does pulse wave velocity measured by CMR or oscillometric methods predict major adverse cardiovascular events in post-infarcted patients?
Cohort (n=75)
Does pulse wave velocity measured by CMR or oscillometric methods predict major adverse cardiovascular events in post-infarcted patients?
Increased pulse wave velocity measured by either oscillometric or CMR methods is a feasible predictor of MACE in post-infarcted patients, though method-specific cut-off values are required.
Increased aortic pulse wave velocity (PWV) has been proved as a strong predictor of major adverse cardiovascular events (MACE) in patients after myocardial infarction (MI). Due to the various technical approaches the level of high PWV values show significant differences. We evaluated the cut-off PWV values for MACE prediction using cardiac magnetic resonance imaging (CMR) and oscillometric methods for validating the prognostic value of high PWV in post-infarcted patients. Phase contrast imaging (PCI) and oscillometric based Arteriograph (AG) were compared in this 6 years follow-up study, including 75 consecutive patients of whom 49 suffered previous ST-elevation myocardial infarction (STEMI). Patients received follow-up for MACE comprising all-cause death, non-fatal MI, ischemic stroke, hospitalization for heart failure and coronary revascularization. An acceptable agreement and significant correlation (rho: 0.332, p < 0.01) was found between AG and CMR derived PWV values. The absolute values, however, were significantly higher for AG (median (IQR): 10.4 (9.2–11.9) vs 6.44 (5.64–7.5) m/s; p < 0.001). Totally 51 MACE events occurred during the 6 years follow-up period in post-infarcted patients. Kaplan-Meier analysis in both methods showed significantly lower event-free survival in case of high PWV (CMR: >6.47 m/s, AG: >9.625 m/s, p < 0.001, respectively). Multivariate Cox regression revealed PWV as a predictor of MACE (PWV CMR hazard ratio (HR): 1.31 (CI: 1.1–1.7), PWV AG HR: 1.24 (CI: 1.0–1.5), p < 0.05, respectively). Increased PWV derived by AG and CMR methods are feasible for MACE prediction in post-infarcted patients. However, adjusted cut-off values of PWV are recommended for different techniques to improve individual risk stratification.
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Meiszterics et al. (2021) conducted a cohort in Myocardial infarction (n=75). High pulse wave velocity (PWV) vs. Low pulse wave velocity was evaluated on Major adverse cardiovascular events (all-cause death, non-fatal MI, ischemic stroke, hospitalization for heart failure and coronary revascularization) (HR 1.31, 95% CI 1.1-1.7, p=<0.05). High pulse wave velocity measured by cardiac MRI (HR 1.31; 95% CI 1.1-1.7) or oscillometric methods (HR 1.24; 95% CI 1.0-1.5) significantly predicted major adverse cardiovascular events over 6 years.
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