Importance of Increased Arterial Resistance in Risk Prediction in Patients with Cardiovascular Risk Factors and Degenerative Aortic Stenosis

被引：10

作者：

Baran, Jakub ^{[1
]}

Kleczynski, Pawel ^{[1
]}

Niewiara, Lukasz ^{[1
,2
]}

Podolec, Jakub ^{[1
]}

Badacz, Rafal ^{[1
]}

Gackowski, Andrzej ^{[3
,4
]}

Pieniazek, Piotr ^{[1
,5
]}

Legutko, Jacek ^{[1
]}

Zmudka, Krzysztof ^{[1
]}

Przewlocki, Tadeusz ^{[1
,5
]}

Kablak-Ziembicka, Anna ^{[1
,4
]}

机构：

[1] Jagiellonian Univ Med Coll, Inst Cardiol, John Paul II Hosp, Dept Intervent Cardiol, PL-31202 Krakow, Poland

[2] Jagiellonian Univ Med Coll, Dept Emergency Med, Fac Hlth Sci, PL-31126 Krakow, Poland

[3] Jagiellonian Univ Med Coll, Inst Cardiol, John Paul II Hosp, Dept Coronary Dis & Heart Failure, PL-31202 Krakow, Poland

[4] John Paul 2 Hosp, Noninvas Cardiovasc Lab, PL-31202 Krakow, Poland

[5] Jagiellonian Univ Med Coll, Inst Cardiol, John Paul II Hosp, Dept Cardiac & Vasc Dis, PL-31202 Krakow, Poland

来源：

JOURNAL OF CLINICAL MEDICINE | 2021年 / 10卷 / 10期

关键词：

cardiovascular risk factors; heart failure; major cardiac and cerebral ischemic events; degenerative aortic stenosis; risk stratification; vascular resistance; INTIMA-MEDIA THICKNESS; STIFFNESS; SEVERITY; PRESSURE;

D O I：

10.3390/jcm10102109

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页数：10