The value of arterial stiffness ?n determining prognosis of patients with advanced stage heart failure

Objective: Increased arterial stiffness is an indicator of mortality. ?t have also a decisive importance for vascular diseases such as renal disease, stroke, dementia, heart failure and myocardial infarction. However, the prognostic significance of arterial stiffness in patients with advanced heart failure is unclear. In our study a one-year mortality in advanced heart failure patients with arterial stiffness was examined.Materials and Methods: The study followed up 87 patients with a diagnosis of heart failureand NYHA class III-IV phase, (71 males, 16 females and mean age of 59.4±11.6 years) All patient?s medical history was taken. Physical examination and echocardiographic examinations were performed. Aix (augmentation index) and PWVao (pulse wave propagation velocity) parameters was used as an indicator of arterial stiffness. Aix and PWVao values were measured by arteriography at the accept the visit. The patients were followed up 374 ±47 days for cardiovascular mortalityResults: During follow-up mortality was observed in 34 (39.1 %) patients. Both Aix and PWVao were found to be powerful determinants independent of other prognostic variables in predicting mortality. (p<0.001, p<0.001) When the cutoff value for Aix was taken as -14.33 with 91.2%, 80.3% sensitivity and specificity, and when the cutoff value for PWVao was taken as 11.06 with 82.4%, 65.4% sensitivity and specificity mortality was predicted. Left ventricular ejection fraction (p=0.08, OR: 0.859) and BUN (p=0.01, OR: 0.833) were found to be the other independent determinants of mortality.Conclusion: Arterial stiffness is an easy, cheap and reliable method in estimating mortality in patients with advanced heart failure.Key Words: Heart failure, arterial stiffness and mortality