Faculty Collaboration Database

Aortic stiffening precedes onset of heart failure with preserved ejection fraction in patients with asymptomatic diastolic dysfunction. BMC Cardiovasc Disord 2017 Feb 14;17(1):62

Date

02/16/2017

Pubmed ID

28196483

Pubmed Central ID

PMC5310057

DOI

10.1186/s12872-017-0490-9

Scopus ID

2-s2.0-85012907344 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

BACKGROUND: Identifying which patients with diastolic dysfunction will progress to heart failure with preserved ejection fraction (HFpEF) remains challenging. The goal of this study is to determine whether increased vascular stiffness as identified on 2D transthoracic echocardiography (TTE) serves as a biomarker for the development of HFpEF in patients with diastolic dysfunction.

METHODS: The study design is a matched retrospective case-control study. Subjects with diastolic dysfunction were divided into two groups based on whether they had a clinical diagnosis of HFpEF. The two groups were matched based on age, gender, race and body surface area, resulting in 77 matched pairs (n = 154). Data from the first TTE that documented diastolic dysfunction prior to the development of HFpEF was extracted along with baseline demographic and clinical data. Indices of vascular stiffness were measured and compared. A sub-group analysis was performed to compare diabetic subjects in Group 1 (n = 43) to those in Group 2 (n = 21).

RESULTS: Group 1 had significantly decreased aortic distensibility as measured on the initial TTE when compared to Group 2 (1.9 ± 1.0 vs. 2.8 ± 1.8 cm²dyne^-110^-3, p = 0.01). In the diabetic subset, Group 1 had significantly less aortic strain (6.9 ± 3.3 vs. 9.7 ± 5.6%, p = 0.02) and aortic distensibility (1.8 ± 1.0 vs. 3.5 ± 2.6 cm²dyne^-110^-3, p = 0.02) compared to Group 2. Other indices of vascular stiffness did not differ significantly between groups.

CONCLUSIONS: This study demonstrates that increased proximal aortic stiffness is associated with the development of HFpEF in patients with asymptomatic diastolic dysfunction. Larger prospective studies are needed to further investigate this relationship.

Author List

Karagodin I, Aba-Omer O, Sparapani R, Strande JL

Author

Rodney Sparapani PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aorta
Asymptomatic Diseases
Diastole
Disease Progression
Echocardiography
Female
Follow-Up Studies
Heart Failure
Humans
Male
Prognosis
Retrospective Studies
Stroke Volume
Time Factors
Vascular Stiffness
Ventricular Dysfunction, Left