Objectives:The radial artery pulse waveform is a continuous measure of pressure throughout the cardiac cycle, and thus can provide more information than just systolic and diastolic blood pressures. New indices based on a Windkessel model of the waveform, PTC1 and PTC2, are related to arterial compliance and add information for prediction of incident cardiovascular disease (coronary heart disease, stroke, myocardial infarction) but their association with heart failure is unknown.Methods:Among 6229 adults (mean age 62 years) from four race/ethnic groups who were initially free of clinical cardiovascular disease and heart failure in 2000-2002, we evaluated the associations of baseline PTC1 and PTC2 with incident heart failure.Results:Mean ± standard deviation PTC1 and PTC2 were 394 ± 334 and 94 ± 46 ms, respectively. During a median of 15.7 years follow-up, there were 357 heart failure events (148 with reduced, 150 with preserved, and 59 with unknown ejection fraction). After adjustment for traditional risk factors, the hazard ratio for heart failure per 1 standard deviation higher PTC2 was 0.73 (95% confidence interval: 0.63 - 0.85). Higher PTC2 was also significantly associated with lower risk of heart failure with reduced ejection fraction (hazard ratio = 0.67; 95% confidence interval: 0.56 - 0.80). There was no evidence of a significant association between PTC2 and heart failure with preserved ejection fraction or between PTC1 and heart failure.Conclusion:The PTC2 measure of the radial artery pulse waveform may represent a novel phenotype related to heart failure, especially heart failure with reduced ejection fraction.
Bibliographical noteFunding Information:
Funding/Disclosures: This research was supported by the National Institutes of Health (HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, R01 HL098382, and R01 HL142283) and the National Center for Advancing Translational Sciences (UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420).
S.J.S. is supported by grants from the National Institutes of Health (R01 HL140731, R01 HL120728, R01 HL107577, and R01 HL149423); the American Heart Association (#16SFRN28780016); Actelion, AstraZeneca, Corvia, Novartis, and Pfizer; and has received consulting fees from Actelion, Amgen, AstraZeneca, Bayer, Boehringer-Ingelheim, Cardiora, CVRx, Cyclerion, Cytokinetics, Eisai, Eli Lilly, Ionis, Merck, MyoKardia, Novartis, Novo Nordisk, Pfizer, Sanofi, Shifamed, Tenax, and United Therapeutics.
© 2021 Wolters Kluwer Health, Inc.
- Windkessel model
- arterial compliance
- radial artery pulse waveform