Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave - UTU Research Portal

A1 Refereed original research article in a scientific journal

Association of Total Mortality and Cardiovascular Endpoints With the Timing of the First and Second Systolic Peak of the Aortic Pulse Wave

Authors: Cheng, Yi-Bang; An, De-Wei; Aparicio, Lucas S.; Huang, Qi-Fang; Yu, Yu-Ling; Sheng, Chang-Sheng; Niiranen, Teemu J.; Wei, Fang-Fei; Boggia, Jose; Stolarz-Skrzypek, Katarzyna; Gilis-Malinowska, Natasza; Tikhonoff, Valerie; Wojciechowska, Wiktoria; Casiglia, Edoardo; Narkiewicz, Krzysztof; Yang, Wen-Yi; Filipovsky, Jan; Kawecka-Jaszcz, Kalina; Wang, Ji-Guang; Nawrot, Tim S.; Li, Yan; Staessen, Jan A.

Publisher: WILEY

Publishing place: HOBOKEN

Publication year: 2025

Journal: Journal of Clinical Hypertension

Journal name in source: JOURNAL OF CLINICAL HYPERTENSION

Journal acronym: J CLIN HYPERTENS

Article number: e14962

Volume: 27

Issue: 1

Number of pages: 10

ISSN: 1524-6175

eISSN: 1751-7176

DOI: https://doi.org/10.1111/jch.14962

Web address : https://onlinelibrary.wiley.com/doi/10.1111/jch.14962

Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/484942902

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.

Downloadable publication

This is an electronic reprint of the original article.
This reprint may differ from the original in pagination and typographic detail. Please cite the original version.

J of Clinical Hypertension - 2025 - Cheng - Association of Total Mortality and Cardiovascular Endpoints With the Timing of.pdf

Funding information in the publication:
Funding: This study was funded by Argentina: The Internal Medicine Service, Hospital Italiano de Buenos Aires, Buenos Aires; Belgium (Leuven): European Union (HEALTH-F7-305507 HOMAGE), European Research Council (Advanced Researcher Grant 2011-294713-EPLORE and Proof-of-Concept Grant 713601-uPROPHET), and European Research Area Net for Cardiovascular Diseases (JTC2017-046-PROACT); China: The National Natural Science Foundation of China (grants 82070432, 82070435, 82270469, 81970353), The National Key Research and Development Projects (2022YFC3602400, 2022YFC3602401), and by the Shanghai Commissions of Science and Technology (grants 19ZR144330, 21TS1400300), the Shanghai Shenkang Hospital Development Center (SHDC2020CR1042B), and the Shanghai Municipal Health Commission (20234Y0036, 202340035, 201940297, GWV-10.1-XK05 and a Grant for Leading Academics 2022LJ022); Czech Republic: European Union (grants LSHM-CT-2006–037093 and HEALTH-F4-2007–201550) and Charles University Research Fund (project P36); Finland: Finnish Research Council, Sigrid Jusélius Foundation, Finnish Foundation for Cardiovascular Research; Italy: European Union (grants LSHM-CT-2006–037093 and HEALTH-F4-2007–201550); Poland (Gdańsk): European Union (grants LSHM-CT-2006–037093 and HEALTH-F4-2007–201550); Poland (Kraków): European Union (grants LSHM-CT-2006–037093 and HEALTH-F4-2007–201550) and Foundation for Polish Science.