The risk of developing chronic heart failure in patients with hypertension depending on the actual arterial stiffness
https://doi.org/10.29001/2073-8552-2020-35-2-98-105
Abstract
Objective. To determine the risk of developing chronic heart failure (CHF) in patients with hypertension (HTN) depending on the actual arterial stiffness.
Material and Methods. The study included 175 patients with HTN without a verified diagnosis of heart failure. The average age was 48.5 ± 6.8 years. Patients underwent general clinical examination, volume sphygmoplethysmography assessments of cardio-ankle vascular index (CAVI), echocardiography study (left ventricular (LV) ejection fraction, LV diastolic function, LV myocardial mass index, indexed LV volume by echocardiography), and tests for serum N-terminal pro-B-type natriuretic peptide (NT-proBNP). Patients were divided into two groups depending on CAVI. Group 1 included 141 (80.6%) patients with CAVI < 9; group 2 included 34 (19.4%) patients with CAVI > 9.
Results. In patients of group 1, the level of NT-proBNP was 0.008 [0.006; 5.770], which was significantly lower than the corresponding value in group 2, where the level of NT-proBNP was 13.08 [0.01; 350.65] ng/mL (p = 0.041). Indicators of odds ratio (OR) and relative risk (RR) were also significant. The chance of developing CHF with CAVI > 9 increased by almost 7 times (OR = 6.9; 95% CI = 2.8–16.8), and OR of CHF onset was 4.1 (95% CI = 2.2–7.6). Sensitivity and specificity rates were 55.9% and 84.4%, respectively. Correlation analysis revealed a medium degree of dependence and direct relationships between NT-proBNP level and CAVI values (r = 0.35; p <0.05).
Conclusion. Serum level of NT-proBNP depended on the actual arterial stiffness. Patients with CAVI > 9 indicative of an increase in true arterial stiffness had a greater risk of developing heart failure assessed based on the level of NT-proBNP in the blood. Further studies are required to assess the effects of arterial stiffness, registered within the intermediate values of CAVI index, on the risk of heart failure onset.
About the Authors
A. I. Chernyavina
Perm State Medical University named after Academician E.A. Wagner
Russian Federation
Russian Federation
Cand. Sci. (Med.), Associate Professor, Department of Propaedeutics of Internal Diseases No. 2,
26, Petropavlovskaya str., Perm, 614990
N. A. Koziolova
Perm State Medical University named after Academician E.A. Wagner
Russian Federation
Russian Federation
Dr. Sci. (Med.), Professor, Head of Department of Propaedeutics of Internal Diseases No. 2,
26, Petropavlovskaya str., Perm, 614990
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For citations:
Chernyavina A.I., Koziolova N.A. The risk of developing chronic heart failure in patients with hypertension depending on the actual arterial stiffness. Siberian Journal of Clinical and Experimental Medicine. 2020;35(2):98-105. (In Russ.) https://doi.org/10.29001/2073-8552-2020-35-2-98-105
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