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Published on: May 3, 2018
Intrinsic Frequencies of Carotid Pressure Waveforms Predict Heart Failure Events: The Framingham Heart Study
Leroy L Cooper1, Jian Rong2, Niema M Pahlevan3,4
1From the Biology Department, Vassar College, Poughkeepsie, NY (L.L.C.).
Insights
Novel arterial waveform measures called intrinsic frequencies (IFs) show promise for predicting cardiovascular disease (CVD) risk. Higher systolic IF (ω₁) and frequency variation (Δω), along with lower diastolic IF (ω₂), are linked to increased incident CVD and heart failure risk.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Epidemiology
Background:
- Intrinsic frequencies (IFs) derived from arterial waveforms are linked to cardiovascular performance, aging, and existing cardiovascular disease (CVD).
- The prognostic value of these novel IF measures for predicting future CVD events remains largely unknown.
- Understanding IFs' role could offer new insights into cardiovascular health and disease risk stratification.
Purpose of the Study:
- To investigate the association between intrinsic frequencies (IFs) and the risk of developing incident cardiovascular disease (CVD).
- To determine if specific IF parameters (ω₁, ω₂, Δω) are predictive of composite CVD events and heart failure.
- To explore the prognostic utility of IFs in a large, community-based cohort free of CVD at baseline.
Main Methods:
- Utilized data from the Framingham Heart Study cohorts (N=4700), including participants without baseline CVD.
- Extracted two dominant intrinsic frequencies (ω₁: systolic, ω₂: diastolic) from carotid pressure waves, calculating total frequency variation (Δω).
- Employed Cox proportional hazards regression models to assess the relationship between IFs and incident CVD events over a mean follow-up of 10.6 years, adjusting for CVD risk factors.
Main Results:
- Higher systolic IF (ω₁) and total frequency variation (Δω), along with lower diastolic IF (ω₂), were significantly associated with an increased risk of composite incident CVD events.
- These associations were particularly pronounced for incident heart failure, with higher ω₁ and Δω, and lower ω₂ correlating with greater risk.
- Intrinsic frequencies did not show significant associations with the risk of incident myocardial infarction or stroke.
Conclusions:
- Novel intrinsic frequencies derived from arterial waveforms may serve as valuable prognostic markers for cardiovascular health.
- Specific IF parameters, particularly ω₁ and Δω, are associated with an elevated risk of incident composite CVD and heart failure.
- IFs show potential as novel biomarkers for identifying individuals at higher risk for heart failure in community settings.
Abstract:
Intrinsic frequencies (IFs) derived from arterial waveforms are associated with cardiovascular performance, aging, and prevalent cardiovascular disease (CVD). However, prognostic value of these novel measures is unknown. We hypothesized that IFs are associated with incident CVD risk. Our sample was drawn from the Framingham Heart Study Original, Offspring, and Third Generation Cohorts and included participants free of CVD at baseline (N=4700; mean age 52 years, 55% women). We extracted 2 dominant frequencies directly from a series of carotid pressure waves: the IF of the coupled heart and vascular system during systole (ω1) and the IF of the decoupled vasculature during diastole (ω2). Total frequency variation (Δω) was defined as the difference between ω1 and ω2. We used Cox proportional hazards regression models to relate IFs to incident CVD events during a mean follow-up of 10.6 years. In multivariable models adjusted for CVD risk factors, higher ω1 (hazard ratio [HR], 1.14 [95% CI], 1.03-1.26]; P=0.01) and Δω (HR, 1.16 [95% CI, 1.03-1.30]; P=0.02) but lower ω2 (HR, 0.87 [95% CI, 0.77-0.99]; P=0.03) were associated with higher risk for incident composite CVD events. In similarly adjusted models, higher ω1 (HR, 1.23 [95% CI, 1.07-1.42]; P=0.004) and Δω (HR, 1.26 [95% CI, 1.05-1.50]; P=0.01) but lower ω2 (HR, 0.81 [95% CI, 0.66-0.99]; P=0.04) were associated with higher risk for incident heart failure. IFs were not significantly associated with incident myocardial infarction or stroke. Novel IFs may represent valuable markers of heart failure risk in the community.
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