Novel, noninvasive measurement a strong predictor for heart failure in general population

November 14, 2011

Orlando -A new study from researchers at the Perelman School of Medicine at the University of Pennsylvania and collaborators at various institutions, presented at the 2011 American Heart Association Scientific Sessions, shows that a novel, non-invasive measurement of arterial wave reflections may be able to predict who is most at risk for heart failure. The authors presented data from an ancillary study of the Multi-Ethnic Study of Atherosclerosis (MESA).

When the heart contracts it generates a pulse or energy wave that travels through the arteries. This wave gets reflected in parts of the arterial tree and returns to the heart while it is ejecting blood, increasing the heart's workload. Increased wave reflections can lead to increased pressure on the heart and have been shown to be independent predictors of cardiovascular morbidity and mortality in populations with established heart disease or advanced kidney disease, but their association with adverse outcomes in the general population has remained unclear. Furthermore, the specific association between increased wave reflections and heart failure had not been shown before.

"Over five million people in the U.S. alone have heart failure, and it results in approximately 300,000 deaths each year. It's critical that we work to discover novel ways to identify patients most at risk," said Julio A. Chirinos, MD, assistant professor of Medicine at Penn and the study's lead author. "We show for the first time in a large general population that people with prominent arterial wave reflections are at greater risk for developing heart failure in the future."

In the current study, Dr. Chirinos and collaborators measured arterial wave reflections with a simple, non-invasive procedure known as arterial tonometry. Arterial tonometry is a technique for blood-pressure measurement in which an array of pressure sensors is pressed against the skin over an artery. The researchers analyzed the radial artery pressure obtained at baseline from 5,958 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) and assessed the relationship between the magnitude of the reflected wave at baseline and incident cardiovascular events (CVE) and congestive heart failure (CHF). All patients in the MESA cohort had no known cardiovascular disease at baseline.

During median 6.46 years of follow-up in the current study, the researchers found that even just a 10 percent increase in wave reflection magnitude was predictive of a higher risk of combined cardiovascular events, hard cardiovascular events, and was strongly predictive of incident heart failure. This measure was a stronger predictor of CHF risk than hypertension and other established modifiable risk factors, as measured by established medical standards and population-based risks. This suggests that wave reflections are important determinants of heart failure risk.

"Although more experimental studies and clinical trials should be pursued to confirm a causal role, these findings interpreted in the context of available data, identify increased wave reflections as a new potential mechanistic risk factor for heart failure in the general population," said Dr. Chirinos. "We hope that this line of research has the potential to lead to therapeutic approaches for prevention of heart failure."

MESA is a longitudinal study of the characteristics of subclinical cardiovascular disease (disease detected non-invasively before it has produced clinical signs and symptoms) and risk factors that predict progression from subclinical to clinically cardiovascular disease, in a diverse population-based sample. Participants in MESA come from diverse race and ethnic groups, including African Americans, Latinos, Asians, and Caucasians. MESA is sponsored by the National Heart, Lung, and Blood Institute of the National Institutes of Health.
-end-
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4 billion enterprise.

Penn's Perelman School of Medicine is currently ranked #2 in U.S. News & World Report's survey of research-oriented medical schools and among the top 10 schools for primary care. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $507.6 million awarded in the 2010 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top 10 hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; and Pennsylvania Hospital - the nation's first hospital, founded in 1751. Penn Medicine also includes additional patient care facilities and services throughout the Philadelphia region.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2010, Penn Medicine provided $788 million to benefit our community.

University of Pennsylvania School of Medicine

Related Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.

Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

Read More: Heart Failure News and Heart Failure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.