Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website http://www.cardiologyres.org

Original Article

Volume 10, Number 3, June 2019, pages 142-149

Clinical Significance of Arterial Velocity Pulse Index in Patients With Stage B Heart Failure With Preserved Ejection Fraction

Figures

Figure 1.
Figure 1. The measurement concept of the AVI. AVI has the characteristics of a pulse wave pattern at higher cuff pressures than the systolic blood pressure. We measured two variables automatically, i.e. Vf (the first peak of the differential of the waveform with respect to time) and Vr (the absolute value of the bottom of the valley of the differential of the waveform with respect to time), and AVI was automatically calculated as 20 × (Vr/Vf). (a) Pulse wave pattern of low AVI levels. (b) Pulse wave pattern of high AVI levels. AVI: arterial velocity pulse index.
Figure 2.
Figure 2. The cutoff value of the AVI for determining high E/e', high hs-cTnT and low calf circumference. (a) High E/e' of > 15; (b) high hs-cTnT of ≥ 0.014 ng/mL; (c) low calf circumference of < 34 cm in males and < 33 cm in females. AVI: arterial velocity pulse index; hs-cTnT: high-sensitivity cardiac troponin T; AUC: area under the curve.

Tables

Table 1. Patient Characteristics
 
Continuous values are mean ± SD. HOMA-IR: homeostasis assessment insulin resistance; IVSTd: interventricular septal thickness at end-diastole; LVDd: left ventricular end-diastolic diameter; LVEF: left ventricular ejection fraction; LAD: left atrial dimension; eGFR: estimated glomerular filtration rate; BNP: brain natriuretic peptide; hs-cTnT: high-sensitivity cardiac troponin T; d-ROMs: derivatives of reactive oxygen metabolites; AVI: arterial velocity pulse index; RAS: renin-angiotensin system.
n (male/female)345 (121/224)
Age (years)74 ± 7
Body height (cm)155 ± 10
Body mass index (kg/m2)22.8 ± 3.8
Calf circumference (cm)32.5 ± 3.0
Current smoker, n (%)56 (16)
Ischemic heart disease, n (%)85 (25)
Hypertension, n (%)256 (74)
Systolic blood pressure (mm Hg)143 ± 22
Diastolic blood pressure (mm Hg)82 ± 10
Pulse rate (/min)70 ± 11
Dyslipidemia, n (%)227 (66)
Diabetes mellitus, n (%)124 (36)
Fasting blood glucose (mg/dL)109 ± 28
HOMA-IR2.1 ± 1.7
Hemoglobin A1c (%)6.2 ± 1.0
Heart valvular disease, n (%)269 (78)
IVSTd (mm)9.8 ± 1.7
LVDd (mm)50.4 ± 3.6
LVEF (%)67.7 ± 8.7
LAD (mm)42.6 ± 5.6
E/e’10.5 ± 3.3
eGFR (mL/min/1.73 m2)49.9 ± 18.9
Log-urinary albumin (mg/g Cr)1.8 ± 0.5
Log-BNP (pg/mL)2.0 ± 0.3
Log-hs-cTnT (ng/mL)-2.0 ± 0.3
d-ROMs test (U. CARR)304 ± 113
AVI30 ± 7
Medication
  RAS inhibitor, n (%)217 (63)
  β blocker, n (%)71 (21)
  Diuretics, n (%)70 (20)
  Statin, n (%)130 (38)

 

Table 2. AVI and Various Clinical Parameters
 
rP value
r expressed correlation coefficient. HOMA-IR: homeostasis assessment insulin resistance; IVSTd: interventricular septal thickness at end-diastole; LVDd: left ventricular end-diastolic diameter; LVEF: left ventricular ejection fraction; LAD: left atrial dimension; eGFR: estimated glomerular filtration rate; BNP: brain natriuretic peptide; hs-cTnT: high sensitivity cardiac troponin T; d-ROMs: derivatives of reactive oxygen metabolites; RAS: renin-angiotensin system.
Sex (female = 0, male = 1)-0.160.002
Age0.18< 0.001
Body height-0.20< 0.001
Body mass index-0.18< 0.001
Calf circumference-0.42< 0.001
Current smoker (no = 0, yes = 1)0.100.072
Ischemic heart disease (no = 0, yes = 1)0.080.160
Hypertension (no = 0, yes = 1)0.020.684
Systolic blood pressure0.030.539
Diastolic blood pressure0.020.730
Pulse rate-0.20< 0.001
Dyslipidemia (no = 0, yes = 1)0.090.078
Diabetes mellitus (no = 0, yes = 1)0.170.002
Fasting blood glucose0.140.009
HOMA-IR0.040.481
Hemoglobin A1c0.090.105
Heart valvular disease0.080.153
IVSTd0.110.043
LVDd0.050.401
LVEF0.030.614
LAD0.070.183
E/e'0.35< 0.001
eGFR-0.120.024
Log-urinary albumin0.34< 0.001
Log-BNP0.23< 0.001
Log-hs-cTnT0.47< 0.001
d-ROMs test0.31< 0.001
RAS inhibitor (no = 0, yes = 1)-0.110.034
β blocker (no = 0, yes = 1)0.080.095
Diuretics (no = 0, yes = 1)0.030.527
Statin (no = 0, yes = 1)-0.110.044

 

Table 3. Multiple Regression Analysis for AVI
 
Explanatory factorβP value
R2 = 0.41. AVI: arterial velocity pulse index; hs-cTnT: high-sensitivity cardiac troponin T; d-ROMs: derivatives of reactive oxygen metabolites; BNP: brain natriuretic peptide; β: standardized regression coefficient; R2: coefficient of determination.
E/e'0.29< 0.001
Log-hs-cTnT0.27< 0.001
Calf circumference-0.26< 0.001
Log-urinary albumin0.16< 0.001
Body height-0.120.005
d-ROMs test0.110.022
Pulse rate-0.100.024
Sex (male)-0.070.125
Log-BNP0.060.189