Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave
ABSTRACT Prognostic significance of the timing in the cardiac cycle of the first (TP1) and second (TP2) systolic peak of the central aortic pulse wave is ill‐defined. Incidence rates and standardized multivariable‐adjusted hazard ratios (HRs) of adverse health outcomes associated with TP1 and TP2, e...
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2025-01-01
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| Series: | The Journal of Clinical Hypertension |
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| Online Access: | https://doi.org/10.1111/jch.14962 |
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| author | Yi‐Bang Cheng De‐Wei An Lucas S. Aparicio Qi‐Fang Huang Yu‐Ling Yu Chang‐Sheng Sheng Teemu J. Niiranen Fang‐Fei Wei José Boggia Katarzyna Stolarz‐Skrzypek Natasza Gilis‐Malinowska Valérie Tikhonoff Wiktoria Wojciechowska Edoardo Casiglia Krzysztof Narkiewicz Wen‐Yi Yang Jan Filipovský Kalina Kawecka‐Jaszcz Ji‐Guang Wang Tim S. Nawrot Yan Li Jan A. Staessen the International Database of Central Arterial Properties for Risk Stratification (IDCARS) Investigators |
| author_facet | Yi‐Bang Cheng De‐Wei An Lucas S. Aparicio Qi‐Fang Huang Yu‐Ling Yu Chang‐Sheng Sheng Teemu J. Niiranen Fang‐Fei Wei José Boggia Katarzyna Stolarz‐Skrzypek Natasza Gilis‐Malinowska Valérie Tikhonoff Wiktoria Wojciechowska Edoardo Casiglia Krzysztof Narkiewicz Wen‐Yi Yang Jan Filipovský Kalina Kawecka‐Jaszcz Ji‐Guang Wang Tim S. Nawrot Yan Li Jan A. Staessen the International Database of Central Arterial Properties for Risk Stratification (IDCARS) Investigators |
| author_sort | Yi‐Bang Cheng |
| collection | DOAJ |
| description | ABSTRACT Prognostic significance of the timing in the cardiac cycle of the first (TP1) and second (TP2) systolic peak of the central aortic pulse wave is ill‐defined. Incidence rates and standardized multivariable‐adjusted hazard ratios (HRs) of adverse health outcomes associated with TP1 and TP2, estimated by the SphygmoCor software, were assessed in the International Database of Central Arterial Properties for Risk Stratification (IDCARS) (n = 5529). Model refinement was assessed by the integrated discrimination (ID) and net reclassification (NR) improvement. Over 4.1 years (median), 201 participants died and 248 and 159 patients experienced cardiovascular or cardiac endpoints. Mean TP1 and TP2, standardized for cohort, sex, age, and heart rate, were 103 and 228 ms. Shorter TP1 and TP2 were associated with higher mortality and shorter TP1 with a higher risk of cardiovascular and cardiac endpoints (trend p ≤ 0.004). The HRs relating total mortality and cardiovascular endpoints to TP2 were 0.82 (95% confidence interval [CI]: 0.72–0.94) and 0.87 (0.77–0.98), respectively. The HR relating cardiac endpoints to TP1 was 0.81 (0.68–0.97). For total mortality and cardiovascular endpoints in relation to TP2, NRI was significant (p ≤ 0.010), but not for cardiac endpoints in relation to TP1. Integrated discrimination improvement (IDI) was not significant for any endpoint. The HRs relating total mortality to TP2 were smaller (p ≤ 0.026) in women than men (0.67 vs. 0.95) and in older (≥ 60 years) versus younger (< 60 years) participants (0.80 vs. 0.88). Our study adds to the evidence supporting risk stratification based on aortic pulse analysis by showing that TP2 and TP1 carry prognostic information. |
| format | Article |
| id | doaj-art-17384becde574c499b46786d0fc76f01 |
| institution | Kabale University |
| issn | 1524-6175 1751-7176 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | The Journal of Clinical Hypertension |
| spelling | doaj-art-17384becde574c499b46786d0fc76f012025-01-31T05:38:36ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-01-01271n/an/a10.1111/jch.14962Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse WaveYi‐Bang Cheng0De‐Wei An1Lucas S. Aparicio2Qi‐Fang Huang3Yu‐Ling Yu4Chang‐Sheng Sheng5Teemu J. Niiranen6Fang‐Fei Wei7José Boggia8Katarzyna Stolarz‐Skrzypek9Natasza Gilis‐Malinowska10Valérie Tikhonoff11Wiktoria Wojciechowska12Edoardo Casiglia13Krzysztof Narkiewicz14Wen‐Yi Yang15Jan Filipovský16Kalina Kawecka‐Jaszcz17Ji‐Guang Wang18Tim S. Nawrot19Yan Li20Jan A. Staessen21the International Database of Central Arterial Properties for Risk Stratification (IDCARS) InvestigatorsDepartment of Cardiovascular Medicine Shanghai Key Laboratory of Hypertension Shanghai Institute of Hypertension State Key Laboratory of Medical Genomics National Research Centre for Translational Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Cardiovascular Medicine Shanghai Key Laboratory of Hypertension Shanghai Institute of Hypertension State Key Laboratory of Medical Genomics National Research Centre for Translational Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaServicio de Clínica Médica, Sección Hipertensión Arterial Hospital Italiano de Buenos Aires Buenos Aires ArgentinaDepartment of Cardiovascular Medicine Shanghai Key Laboratory of Hypertension Shanghai Institute of Hypertension State Key Laboratory of Medical Genomics National Research Centre for Translational Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaNon‐Profit Research Association Alliance for the Promotion of Preventive Medicine Leuven BelgiumDepartment of Cardiovascular Medicine Shanghai Key Laboratory of Hypertension Shanghai Institute of Hypertension State Key Laboratory of Medical Genomics National Research Centre for Translational Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Chronic Disease Prevention Finnish Institute for Health and Welfare Turku FinlandDepartment of Cardiology the First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaCentro de Nefrología and Departamento de Fisiopatología Hospital de Clínicas Universidad de la República Montevideo UruguayFirst Department of Cardiology, Interventional Electrocardiology and Hypertension Jagiellonian University Medical College Kraków PolandHypertension Unit, Department of Hypertension and Diabetology Medical University of Gdańsk Gdańsk PolandDepartment of Medicine University of Padua Padua ItalyFirst Department of Cardiology, Interventional Electrocardiology and Hypertension Jagiellonian University Medical College Kraków PolandDepartment of Medicine University of Padua Padua ItalyHypertension Unit, Department of Hypertension and Diabetology Medical University of Gdańsk Gdańsk PolandDepartment of Cardiology Shanghai General Hospital Shanghai ChinaFaculty of Medicine Charles University Pilsen Czech RepublicFirst Department of Cardiology, Interventional Electrocardiology and Hypertension Jagiellonian University Medical College Kraków PolandDepartment of Cardiovascular Medicine Shanghai Key Laboratory of Hypertension Shanghai Institute of Hypertension State Key Laboratory of Medical Genomics National Research Centre for Translational Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaResearch Unit Environment and Health, Department of Public Health and Primary Care University of Leuven Leuven BelgiumDepartment of Cardiovascular Medicine Shanghai Key Laboratory of Hypertension Shanghai Institute of Hypertension State Key Laboratory of Medical Genomics National Research Centre for Translational Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Cardiovascular Medicine Shanghai Key Laboratory of Hypertension Shanghai Institute of Hypertension State Key Laboratory of Medical Genomics National Research Centre for Translational Medicine Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaABSTRACT Prognostic significance of the timing in the cardiac cycle of the first (TP1) and second (TP2) systolic peak of the central aortic pulse wave is ill‐defined. Incidence rates and standardized multivariable‐adjusted hazard ratios (HRs) of adverse health outcomes associated with TP1 and TP2, estimated by the SphygmoCor software, were assessed in the International Database of Central Arterial Properties for Risk Stratification (IDCARS) (n = 5529). Model refinement was assessed by the integrated discrimination (ID) and net reclassification (NR) improvement. Over 4.1 years (median), 201 participants died and 248 and 159 patients experienced cardiovascular or cardiac endpoints. Mean TP1 and TP2, standardized for cohort, sex, age, and heart rate, were 103 and 228 ms. Shorter TP1 and TP2 were associated with higher mortality and shorter TP1 with a higher risk of cardiovascular and cardiac endpoints (trend p ≤ 0.004). The HRs relating total mortality and cardiovascular endpoints to TP2 were 0.82 (95% confidence interval [CI]: 0.72–0.94) and 0.87 (0.77–0.98), respectively. The HR relating cardiac endpoints to TP1 was 0.81 (0.68–0.97). For total mortality and cardiovascular endpoints in relation to TP2, NRI was significant (p ≤ 0.010), but not for cardiac endpoints in relation to TP1. Integrated discrimination improvement (IDI) was not significant for any endpoint. The HRs relating total mortality to TP2 were smaller (p ≤ 0.026) in women than men (0.67 vs. 0.95) and in older (≥ 60 years) versus younger (< 60 years) participants (0.80 vs. 0.88). Our study adds to the evidence supporting risk stratification based on aortic pulse analysis by showing that TP2 and TP1 carry prognostic information.https://doi.org/10.1111/jch.14962cardiovascular riskmortalitypopulation sciencepulse wave transit timewaveform analysis |
| spellingShingle | Yi‐Bang Cheng De‐Wei An Lucas S. Aparicio Qi‐Fang Huang Yu‐Ling Yu Chang‐Sheng Sheng Teemu J. Niiranen Fang‐Fei Wei José Boggia Katarzyna Stolarz‐Skrzypek Natasza Gilis‐Malinowska Valérie Tikhonoff Wiktoria Wojciechowska Edoardo Casiglia Krzysztof Narkiewicz Wen‐Yi Yang Jan Filipovský Kalina Kawecka‐Jaszcz Ji‐Guang Wang Tim S. Nawrot Yan Li Jan A. Staessen the International Database of Central Arterial Properties for Risk Stratification (IDCARS) Investigators Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave The Journal of Clinical Hypertension cardiovascular risk mortality population science pulse wave transit time waveform analysis |
| title | Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave |
| title_full | Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave |
| title_fullStr | Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave |
| title_full_unstemmed | Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave |
| title_short | Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave |
| title_sort | association of total mortality and cardiovascular endpoints with the timing of the first and second systolic peak of the aortic pulse wave |
| topic | cardiovascular risk mortality population science pulse wave transit time waveform analysis |
| url | https://doi.org/10.1111/jch.14962 |
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