الفهرس 
Non-invasive assessment of central arterial stiffness using oscillometric blood pressure measurement in patients with acute decompensated state of chronic systolic heart failure
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Abstract
Background: Arterial stiffness is strongly linked to the pathogenesis of heart failure (HF), and development of acute decompensation of patients with stable chronic HF. When measured by pulse wave velocity (PWV) and arterial wave reflection indices, arterial stiffness was higher in patients with HF in comparison to normal people. Aim of this study: To compare the arterial stiffness indices measured by the Mobil-O-Graph 24h PWA device in patients with heart failure with reduced ejection fraction (HFrEF) during hospitalization with acute decompensated state, and then three months later after discharge during the compensated state. Methods: A total of 100 patients (80 men; aged 51.6 ± 6.1 years) with acute decompensated HFrEF (NYHA class III and IV) and left ventricular ejection fraction (LVEF) {u2264}35% were included in the study. Fifty-six patients (56%) had ischemic cardiomyopathy (ICM) and the rest had idiopathic dilated cardiomyopathy (DCM). During the initial and follow-up visits, all patients were subjected to full medical history taking, clinical examination, electrocardiography (ECG), transthoracic echocardiography (TTE), routine labs, and non-invasive pulse wave analysis (PWA) by the Mobil-O-Graph 24h PWA device for measurement of arterial stiffness parameters; central pulse pressure (cPP), PWV, augmentation pressure (AP), augmentation index (AIx@75), and reflection magnitude (RM). Results: There was a significant reduction of arterial stiffness parameters in patients with HFrEF during the compensated state as compared to their initial values during the decompensated state (PWV: 8.0 ± 1.3 vs 8.9 ± 1.3 m/sec, P < 0.001; AP: 6.3 ± 4.1 vs 12.5 ± 7.8 mmHg, P < 0.001; AIx@75: 14.1 ± 5.9% vs 21.7 ± 10.2%, P < 0.001; RM: 45.5 ± 9.2% vs 59.0 ± 9.3%, P < 0.001). Patients with ICM had significantly higher PWV than DCM patients (9.2 ± 1.1 vs 8.6 ± 1.4 m/sec, P = 0.042)