Implications of pulse wave velocity and central pulse pressure in heart failure with reduced ejection fraction

• Published in: Blood pressure Vol. 33; no. 1; p. 2359932
• Main Authors: Kõre, Anette Caroline, Joonsalu, Tuuli, Serg, Martin, Pauklin, Priit, Voitk, Jüri, Roose, Indrek, Eha, Jaan, Kampus, Priit
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Group 01-12-2024
• Subjects: Aged; arterial stiffness; Blood Pressure - physiology; central hemodynamics; central pulse pressure; Cross-Sectional Studies; Echocardiography; Female; Heart Failure - physiopathology; Heart failure with reduced ejection fraction; Humans; Male; Middle Aged; Prospective Studies; Pulse Wave Analysis; pulse wave velocity; Stroke Volume; Vascular Stiffness; arterial stiffness; central pulse pressure; Heart failure with reduced ejection fraction; central hemodynamics; pulse wave velocity; pulse wave analysis
• ISSN: 0803-7051; 1651-1999
• DOI: 10.1080/08037051.2024.2359932

Carotid-femoral pulse wave velocity (cfPWV) and central pulse pressure (PP) are recognised as significant indicators of vascular health and predictors of cardiovascular outcomes. In this study, associations between central hemodynamics and left ventricular (LV) echocardiographic parameters were investigated in subjects with heart failure with reduced ejection fraction (HFrEF), comparing the results to healthy individuals.
This cross-sectional prospective controlled study included 50 subjects with HFrEF [mean LV ejection fraction (EF) 26 ± 6.5%] and 30 healthy controls (mean LVEF 65.9 ± 5.3%). Pulse wave analysis (PWA) and carotid-femoral pulse wave velocity (cfPWV) were used to measure central hemodynamics and arterial stiffness. The HFrEF group displayed higher cfPWV (8.2 vs. 7.2 m/s,
 = 0.007) and lower central (111.3 vs. 121.7 mmHg,
 = 0.001) and peripheral (120.1 vs. 131.5 mmHg,
 = 0.002) systolic blood pressure. Central pulse pressure (PP) was comparable between the two groups (37.6 vs. 40.4 mmHg,
 = 0.169). In the HFrEF group, cfPWV significantly correlated with left ventricular end-diastolic volume (LVEDV) index (mL/m
) and LVEF, with LVEDV index being a significant independent predictor of cfPWV (R
= 0.42,
 = 0.003). Central PP was significantly associated with heart rate, LVEF and LVEDV index, with the latter being a significant independent predictor of central PP (R
= 0.41,
 < 0.001). These correlations were not observed in healthy controls.
Significant associations between central hemodynamic measures and LV echocardiographic parameters were identified, suggesting the potential to use PWA and cfPWV as possible tools for managing HFrEF.