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October 27, 2017Journal of Hypertension

Clinical significance of brachial–ankle pulse-wave velocity in patients with heart failure with preserved left ventricular ejection fraction

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Key result

Peripheral artery disease was a significant independent predictor of cardiovascular events in patients with HFpEF (HR 1.85; 95% CI 1.01-3.39; P=0.04).

Why the study?

Does brachial-ankle pulse-wave velocity and presence of peripheral artery disease predict cardiovascular outcomes in patients with HFpEF?

Population

502 patients with heart failure with preserved left ventricular ejection fraction (HFpEF)

Comparison

Measurement of brachial-ankle pulse-wave… vs Patients without PAD, and comparison across…

Design

Cohort

Follow-up

mean 1017 days

Authors

TTTakanori TokitsuKihoku hospitalEYEiichiro YamamotoSapporo Medical UniversityFOFumi OikeHeart Failure / Cardiomyopathy

Discussion

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Implication

May refine CV risk stratification in HFpEF; leaves open whether PAD-targeted interventions improve outcomes.

Study Design

Type

Cohort (n=502)

Structured PICO

Does brachial-ankle pulse-wave velocity and presence of peripheral artery disease predict cardiovascular outcomes in patients with HFpEF?

P
Population
502 patients with heart failure with preserved left ventricular ejection fraction followed for a mean of 1017 days.
E
Exposure
Measurement of brachial-ankle pulse-wave velocity (baPWV) using an ankle-brachial pressure index device, and assessment of peripheral artery disease (PAD)
C
Comparator
Patients without PAD, and comparison across baPWV quintiles
O
Outcome
All-cause mortality and total cardiovascular eventshard clinical

Main Result

Hazard Ratio: 1.85 (95% CI 1.01–3.39)

p-value: p=0.04

Identifying complications of PAD and measuring baPWV values in HFpEF patients can improve risk stratification for cardiovascular events.

Cite This Study

Tokitsu et al. (2017) conducted a cohort in heart failure with preserved left ventricular ejection fraction (HFpEF) (n=502). Peripheral artery disease (PAD) vs. Without PAD was evaluated on cardiovascular events (HR 1.85, 95% CI 1.01-3.39, p=0.04). Peripheral artery disease was a significant independent predictor of cardiovascular events in patients with HFpEF (HR 1.85; 95% CI 1.01-3.39; P=0.04).

synapsesocial.com/papers/6a21190e38e3bbbbff02ba7ehttps://doi.org/10.1097/hjh.0000000000001589

Topics

HFrEF treatmentHeart failureWomen and heart diseaseHFpEF management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of Peripheral Arterial Disease on Outcomes in Advanced Chronic Systolic Heart Failure2009 · 42 citations
  2. 2Aortic stiffness is associated with atherosclerosis of the coronary arteries in older adults: the Rotterdam Study2006 · 113 citations
  3. 3Afterload induced changes in myocardial relaxation A mechanism for diastolic dysfunction1999 · 257 citations
  4. 4Clinical Significance of Pulse Pressure in Patients with Heart Failure with Preserved Left Ventricular Ejection Fraction2016 · 39 citations
  5. 5Pulsatile Hemodynamics in Patients With Exertional Dyspnea2013 · 120 citations