Prognostic significance of mechanical biomarkers derived from pulse wave analysis for predicting long-term cardiovascular mortality in two population-based cohorts

Hao Min Cheng, Shao Yuan Chuang, Jiun Jr Wang, Yuan Ta Shih, Hsin Ning Wang, Chi Jung Huang, Jui Tzu Huang, Shih Hsien Sung, Edward Lakatta, Frank C P Yin, Pesus Chou, Chih Jung Yeh, Chyi Huey Bai, Wen Harn Pan, Chen Huan Chen

Research output: Contribution to journalArticle

Abstract

Background Numerous mechanical biomarkers derived from pulse wave analysis (PWA) have been proposed to predict cardiovascular outcomes. However, whether these biomarkers carry independent prognostic value and clinical utility beyond traditional cardiovascular risk factors hasn't been systematically evaluated. We aimed to investigate the additive utility of PWA-derived biomarkers in two independent population-based cohorts. Methods PWA on central arterial pressure waveforms obtained from subjects without a prior history of cardiovascular diseases of two studies was conducted based on the wave transmission and reservoir-wave theory: firstly in the Kinmen study (1272 individuals, a median follow-up of 19.8 years); and then in the Cardiovascular Disease Risk Factors Two-Township Study (2221 individuals, median follow-up of 10 years). The incremental value of the biomarkers was evaluated by net reclassification index (NRI). Results In multivariate Cox analyses accounting for age, gender, body mass index, systolic blood pressure, fasting glucose, high-density- and low-density-lipoprotein cholesterol, and smoking, only systolic (SC) and diastolic rate constant (DC) of reservoir pressure could independently and consistently predict cardiovascular mortality in both cohorts and the combined cohort (SC: hazard ratio 1.18 [95% confidence interval 1.08-1.28, p < 0.001; DC: 1.18 [1.09-1.28], p < 0.001]. Risk prediction estimates in traditional risk prediction models were significantly more accurate when incorporating peak of reservoir pressure (NRI = 0.049, p = 0.0361), SC (NRI = 0.043, p = 0.0236) and DC (NRI = 0.054, p = 0.047). Conclusions Of all PWA-derived biomarkers, SC and DC were consistently identified as valuable parameters for incremental cardiovascular risk prediction in two large prospective cohorts.

Original languageEnglish (US)
Pages (from-to)388-395
Number of pages8
JournalInternational Journal of Cardiology
Volume215
DOIs
StatePublished - Jul 15 2016
Externally publishedYes

Keywords

  • Epidemiology
  • Mortality
  • Pulse wave analysis
  • Reservoir pressure
  • Vascular aging
  • Wave reflection

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Cheng, H. M., Chuang, S. Y., Wang, J. J., Shih, Y. T., Wang, H. N., Huang, C. J., Huang, J. T., Sung, S. H., Lakatta, E., Yin, F. C. P., Chou, P., Yeh, C. J., Bai, C. H., Pan, W. H., & Chen, C. H. (2016). Prognostic significance of mechanical biomarkers derived from pulse wave analysis for predicting long-term cardiovascular mortality in two population-based cohorts. International Journal of Cardiology, 215, 388-395. https://doi.org/10.1016/j.ijcard.2016.04.070