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

Cheng, Yi-Bang
Author Cheng, Yi-Bang ORCID Department 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, China
An, De-Wei
Author An, De-Wei ORCID Department 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, China Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Leuven, Belgium Research Unit Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
Aparicio, Lucas S
Author Aparicio, Lucas S Servicio de Clínica Médica, Sección Hipertensión Arterial, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Huang, Qi-Fang
Author Huang, Qi-Fang ORCID Department 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, China
Yu, Yu-Ling
Author Yu, Yu-Ling ORCID Non-Profit Research Association Alliance for the Promotion of Preventive Medicine, Leuven, Belgium Research Unit Environment and Health, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
Sheng, Chang-Sheng
Author Sheng, Chang-Sheng ORCID Department 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, China
Niiranen, Teemu J
Author Niiranen, Teemu J ORCID Department of Chronic Disease Prevention, Finnish Institute for Health and Welfare, Turku, Finland Department of Medicine, Turku University Hospital and University of Turku, Turku, Finland
Wei, Fang-Fei
Author Wei, Fang-Fei ORCID Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
Boggia, José
Author Boggia, José ORCID Centro de Nefrología and Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
Stolarz-Skrzypek, Katarzyna
Author Stolarz-Skrzypek, Katarzyna ORCID First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland

The journal of clinical hypertension. 2025 ; 27 (1) : e14962. [pub] -

J Clin Hypertens (Greenwich)
ISSN 1751-7176
Medvik
Source

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.

MeSH
Pulse Wave Analysis * methods MeSH
Aorta physiopathology MeSH
Risk Assessment methods statistics & numerical data MeSH
Hypertension epidemiology mortality physiopathology MeSH
Cardiovascular Diseases * mortality epidemiology MeSH
Middle Aged MeSH
Humans MeSH
Prognosis MeSH
Risk Factors MeSH
Aged MeSH
Heart Rate physiology MeSH
Systole physiology MeSH
Vascular Stiffness physiology MeSH
Check Tag
Middle Aged MeSH
Humans MeSH
Male MeSH
Aged MeSH
Female MeSH
Publication type
Journal Article MeSH

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