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. 2024 May 6;13(9):2719.
doi: 10.3390/jcm13092719.

Role of Vascular Function in the Prognosis of Heart Failure Patients

Shunsuke Kiuchi  1 , Shinji Hisatake  1 , Shintaro Dobashi  1 , Yoshiki Murakami  1 , Takanori Ikeda  1
Affiliations

Role of Vascular Function in the Prognosis of Heart Failure Patients

Shunsuke Kiuchi et al. J Clin Med. .

Abstract

Background: Blood vessels have the Windkessel effect and are involved in blood circulation. The breakdown of this mechanism is also involved in the pathogenesis of heart failure (HF); however, the relationship between vascular dysfunction and HF prognosis is not fully understood. Methods: We evaluated 214 patients hospitalized for HF at our institution who underwent a cardio-ankle vascular index (CAVI), which evaluates vascular function, between January 2012 and July 2018. To investigate factors (including CAVI) associated with major adverse cardiac events (MACE) during 1 year after patients with HF were discharged, we evaluated clinical profiles, blood tests, chest X-P, 12-lead electrocardiography, and transthoracic echocardiographic findings. MACE was defined as cardiovascular death or readmission for HF. Results: The severity of HF between the MACE and non-MACE was not significantly different. Previous HF and chronic kidney disease were significantly more common in the MACE group. CAVI and % mean atrial pressure in the MACE group were statistically higher than those in the non-MACE group. The cardiac shadow as shown by chest X-P and left ventricular size in the MACE group were significantly bigger, and HF preserved ejection fraction (EF) (EF > 50%) was significantly more common in the MACE group. In multivariate analysis, CAVI was an independent predictive factor for the occurrence of MACE (model 1; hazard ratio (HR): 1.33, 95% confidence interval (CI): 1.05-1.68, p = 0.018; model 2; HR: 1.31, 95% CI: 1.07-1.60, p = 0.009). Conclusions: Because high CAVI is associated with poor prognosis of HF, these patients require more careful treatment.

Keywords: anemia; blood pressure in-hospital variability; cardio–ankle brachial index; heart failure; prognosis.

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Conflict of interest statement

The authors declare no conflicts of interest for the present study.

Figures

Figure 1
Figure 1
The Windkessel effect. During cardiac systole, approximately 60% of the blood ejected from the left ventricle pools in blood vessels (a), and during cardiac diastole, the pooled blood returns to the periphery (b).
Figure 2
Figure 2
Selection of study populations. This flow chart illustrates the selection method of the present study’s participants. Overall, 214 consecutive heart failure patients were analyzed.
Figure 3
Figure 3
Graphic illustration of the CAVI measurement method.
Figure 4
Figure 4
Major adverse cardiac events (MACE) within 1 year after discharge were compared between high and low cardio–ankle brachial index (CAVI) groups. Number of MACE within 1 year after discharge in the high CAVI group was significantly more, compared with the low CAVI group.
Figure 5
Figure 5
MACE within 1 year after discharge in the preserved CAVI group. Cardiovascular death (a) was similar in both groups. However, rehospitalization of heart failure (b) in the high CAVI group was significantly more, compared with the low CAVI group.
See this image and copyright information in PMC

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