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Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
The Role of Arterial Stiffness in the Estimation of Cardiovascular Risk in Liver Transplant Recipients
Lydia Sastre1,2, Raquel García1, Julián-Gonzalo Gándara1
1Liver Transplant Unit, Liver Unit, IDIBAPS, CIBERehd, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Insights
Aortic pulse wave velocity (aPWV) may help identify cardiovascular risk in liver transplant recipients. This arterial stiffness measure could improve risk stratification and preventive strategies post-transplant.
Area of Science:
- Cardiology
- Hepatology
- Vascular Biology
Background:
- Long-term cardiovascular events are a major cause of death and disability post-liver transplant (LT).
- Accurate cardiovascular (CV) risk stratification is lacking for LT recipients, hindering preventive strategies.
- Aortic pulse wave velocity (aPWV), a marker of arterial stiffness, has not been evaluated in adult LT recipients.
Purpose of the Study:
- To evaluate aortic pulse wave velocity (aPWV) as a biomarker for cardiovascular risk in adult liver transplant (LT) recipients.
- To assess the association between aPWV and the incidence of CV events after LT.
- To determine if aPWV can improve CV risk stratification in this population.
Main Methods:
- A prospective, single-center study included 122 LT recipients at 12, 60, or 120 months post-LT.
- Aortic pulse wave velocity (aPWV) was measured using oscillometry.
- Clinical CV risk factors, standard risk scores, and CV event incidence during follow-up were assessed.
Main Results:
- Higher aPWV was independently associated with age and blood pressure control.
- During a median 35-month follow-up, 15 patients (12%) experienced a CV event.
- Independent predictors of CV events included higher aPWV, smoking, and elevated triglycerides.
Conclusions:
- Aortic pulse wave velocity (aPWV) reflects cardiovascular risk in liver transplant recipients.
- aPWV may serve as a valuable CV risk biomarker in this patient group.
- Further studies are needed to confirm the accuracy of aPWV in risk stratification.
Background:
Long-term cardiovascular (CV) events are a frequent cause of death and disability after liver transplant (LT). Although a more in-depth, risk-adapted control of CV risk factors may result in improved post-LT CV outcomes, an accurate stratification of the CV risk of LT recipients to better implement preventive strategies is lacking. Aortic pulse wave velocity (aPWV) is a surrogate of arterial stiffness that has been suggested as a biomarker of CV risk; it has never been evaluated in adult LT recipients.
Methods:
In a single-center prospective study, we included 122 LT recipients at 12 (n = 39), 60 (n = 45), or 120 (n = 38) mo after LT. aPWV estimation by oscillometry, clinical assessment of CV risk factors, and CV risk estimation by standard clinical scores (systematic coronary risk evaluation and pooled cohort equation) were performed. The incidence of CV events during prospective follow-up was registered.
Results:
aPWV was independently associated with age and the grade of control of blood pressure. After a median follow-up of 35 mo, 15 patients (12%) presented a CV event. Higher aPWV, diabetes, past or present smoking habit, previous CV events, lower eGFR, being in systematic coronary risk evaluation or pooled cohort equation high-risk groups, and higher levels of total cholesterol, LDL-cholesterol, creatinine, and triglycerides were associated with the incidence of CV events at univariate analysis; aPWV, past or present smoking habit, and triglycerides were independent predictors of CV events.
Conclusions:
According to our results, aPWV mirrors CV risk in LT recipients and thus may be a useful CV risk biomarker in this population. Considering these preliminary results, its accuracy in stratifying risk requires confirmation in further studies.
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