Related Experiment Video
Updated: Jan 2, 2026
Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis
Published on: September 26, 2018
Impact of Simultaneous Consideration of Cardiac and Vascular Function on Long-Term All-Cause and Cardiovascular
Po-Chao Hsu1,2, Wen-Hsien Lee1,2,3, Wei-Chung Tsai1,2
1Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan.
Insights
Assessing both cardiac function (left ventricular ejection fraction) and vascular function (brachial-ankle pulse wave velocity) together improves prediction of cardiovascular mortality. Patients with impaired cardiac and vascular function face the highest mortality risk.
Area of Science:
- Cardiology
- Vascular Medicine
- Preventive Cardiology
Background:
- Left ventricular ejection fraction (LVEF) measures cardiac function.
- Brachial-ankle pulse wave velocity (baPWV) assesses vascular function.
- Both LVEF and baPWV are established predictors of cardiovascular outcomes.
Purpose of the Study:
- To investigate the combined impact of cardiac and vascular function on all-cause and cardiovascular mortality.
- To evaluate mortality risk stratification by simultaneously considering LVEF and baPWV.
Main Methods:
- 958 patients were categorized into four groups based on LVEF (≥50% vs. <50%) and baPWV (below vs. above median).
- Follow-up for mortality was conducted over a median of 93 months.
- Multivariable analysis identified predictors of all-cause and cardiovascular mortality.
Main Results:
- Patients with low LVEF and high baPWV exhibited the highest all-cause and cardiovascular mortality.
- Patients with preserved LVEF and low baPWV had similar mortality rates to those with preserved LVEF and elevated baPWV.
- Low LVEF alone was associated with higher cardiovascular mortality compared to high baPWV alone.
Conclusions:
- Simultaneous assessment of cardiac and vascular function provides valuable prognostic information.
- Combining LVEF and baPWV aids in predicting overall and cardiovascular mortality more effectively.
- Identifying patients with dual cardiac and vascular impairment is crucial for risk stratification.
Abstract:
Background: Left ventricular ejection fraction (LVEF) is a good indicator of cardiac function, and brachial-ankle pulse wave velocity (baPWV) is a good indicator of vascular function. Both of them can predict cardiovascular (CV) outcomes. Objectives: There is scarce literature discussing the impact of simultaneous consideration of cardiac and vascular function on overall and CV mortality. Methods: We included 958 patients and classified them into four groups. Groups 1 to 4 were patients with LVEF ≥ 50% and baPWV below the median, LVEF < 50% but baPWV below the median, LVEF ≥ 50% but baPWV above the median, and LVEF < 50% and baPWV above the median, respectively. Results: The median follow-up to mortality was 93 (25th-75th percentile: 69-101) months. There were 91 cases of CV mortality and 238 cases of all-cause mortality. After multivariable analysis, age, gender, diabetes, mean blood pressure, group 2 versus group 1, and group 4 versus group 1 were significant predictors of all-cause mortality (P ≤ 0.038) and age, diabetes, mean blood pressure, group 2 versus group 1, and group 4 versus group 1 were significant predictors of CV mortality (P ≤ 0.008). Conclusions: Patients with higher LVEF and lower baPWV had a similar overall and CV mortality as patients with higher LVEF and baPWV. Patients with lower LVEF and higher baPWV had the highest overall and CV mortality among the four study groups. In addition, patients with lower LVEF alone had a higher CV mortality than the patients with higher baPWV alone. Therefore, simultaneous consideration of cardiac and vascular function may be useful in predicting overall and CV mortality.
Related Concept Videos
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:29Pathophysiology of Cardiac Performance
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications
01:19Cardiac Output I:Effect of Heart Rate on Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...