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Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
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A retrospective cohort study on the interaction between arterial stiffness and insulin resistance in chronic heart

Lingyu Ma1, Wei Guo1, Jinhua Bi1

  • 1Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.

European Journal of Medical Research
|March 6, 2026
PubMed

Insights

In chronic heart failure (CHF), high arterial stiffness (ePWV) and insulin resistance (TyG index) significantly increase cardiovascular death risk. Their combined elevation poses a synergistic threat, highlighting the need for integrated management strategies.

Area of Science:

  • Cardiology
  • Metabolic Syndrome
  • Vascular Biology

Background:

  • Arterial stiffness and insulin resistance are independent risk factors for chronic heart failure (CHF).
  • The interactive relationship between arterial stiffness and insulin resistance in the context of CHF is not well understood.
  • Investigating this interaction is crucial for understanding CHF progression and mortality.

Purpose of the Study:

  • To investigate the combined impact of arterial stiffness and insulin resistance on cardiovascular mortality in CHF patients.
  • To explore the synergistic or additive effects of elevated estimated pulse wave velocity (ePWV) and triglyceride-glucose index (TyG).
  • To quantify the interaction effect on cardiovascular mortality risk.

Main Methods:

  • Analysis of 1,162 hospitalized CHF patients.
  • Calculation of estimated pulse wave velocity (ePWV) and triglyceride-glucose index (TyG).
  • Stratification into four groups based on ePWV and TyG medians, employing restricted cubic spline and Cox regression analyses to assess mortality risk and interactions.

Main Results:

  • A J-shaped association was observed between ePWV and cardiovascular mortality risk.
  • Concomitant elevation of both ePWV and TyG significantly increased cardiovascular mortality risk (HR=2.99).
  • Additive interaction analysis revealed a synergistic effect, with 52% of the risk attributable to the interaction between ePWV and TyG.

Conclusions:

  • Combined elevation of arterial stiffness (ePWV) and insulin resistance (TyG) significantly elevates cardiovascular mortality risk in CHF patients.
  • A synergistic interaction exists between ePWV and TyG, contributing substantially to mortality risk.
  • These findings underscore the importance of assessing and managing both arterial stiffness and insulin resistance in CHF management.
Abstract

Keywords:
Arterial stiffnessChronic heart failureEstimated pulse wave velocityInsulin resistanceTriglyceride-glucose index

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