Systemic Arterial Stiffness in New Diagnosed Idiopathic Pulmonary Arterial Hypertension Patients

Figures & data

Table 1 Patients' Characteristics in Groups (M±SD), n (%)

Patterns	Group 1 (IPAH) n=45	Group 2 (Arterial Hypertension) n=32	Control Group n=35
Age, years	42.0±12.7	41.7±12.2	41.4±11.2
Female/male, n (%)	37 (82.2)/8 (17.8)	20 (62.5)/12 (37.5)	28 (80)/7 (20)
History of smoking, n (%)	6 (13.3)	9 (28.1)	6 (17.1)
SBP, mmHg	108.6±16.1*	146.1±10.7	114.5±10.6*
DBP, mmHg	74.6±8.9*	94.2±9.8	70.4±10.3*
PBP, mmHg	34.6±12.5*^,#	51.9±10.3	44.2±10.5*
HR, beats per min	76.0±12.1^#,*	72.8±13.4	69.7±9.4*
Body mass index, kg/m^2	25.3±2.8	25.4±3.8	25.5±3.3
Total cholesterol, mmol/L	4.4±2.3*	4.9±3.1	4.5±3.4*
GFR-EPI, mL/min/1.73m^2	79.4±9.3^#	82.1±10.2	99.4±11.8*
Fasting glucose, mmol/L	4.9±3.3	5.0±2.5	4.8±4.4
6MWT, m	330.2±14.6*^,#	523.8±35.3	560.9±30.2*
Borg score, point	6.2±1.8*^,#	1.2±2.1	0.9±2.8
LVEF, %	68.4±5.1	62.2±6.3	72.2±12.1
TAPSE, mm	16.4±3.1*^,#	20.2±3.8	22.2±5.1
Eccentricity index (RV/LV)	1.67±0.8*^,#	0.88±0.4	0.78±0.5
Peak TRV, m/s	3.9±1.1*	1.96±0.8	Not measurable
mPAP, mmHg	58.9± 3.9	–	–
PVR, dynes*s/cm^5	1164.9±104.1	–	–
CI, mL/min/m^2	2.22±0.15	–	–
SVR, dynes*s/cm^5	1693.7±411.3**^,##	1982.2±511.8	1242.2±324.6*

Notes: *P<0.001 in comparison with arterial hypertension groups; **P<0.01 in comparison with arterial hypertension groups; ^#P<0.01 in comparison with control group; ^##P<0.001 in comparison with control group.

Abbreviations: DBP, diastolic blood pressure; SBP, systolic blood pressure; PBP, pulse blood pressure; HR, heart rate; RV, right ventricle; LV, left ventricle; TRV, tricuspid regurgitation velocity; LVEF, left ventricle ejection fraction; PVR, pulmonary vascular resistance; CI, cardiac output index; mPAP, mean pulmonary arterial pressure; TAPSE, tricuspid annular plane systolic excursion; 6MWT, 6-minute walk test; SVR, systemic vascular resistance.

Table 2 Central Blood Pressure and Arterial Stiffness Characteristics in Groups (M±SD)

Patterns	Group 1 (IPAH) n=45	Group 2 (Arterial Hypertension) n=32	Control Group n=35
Aortic SBP, mmHg	99.3±10.6*	128.1±20.1	101.6±9,3
AIx, %	13.2±10.6**	21.6±17.8	13.6±16.3
AIx@75, %	13.5±10.6	18.4±15.3	11.2±9.3
PWVm, m/s	8.1±1.9***^,#	10.3±1.5	6.63±1.34*
PWVe, m/s	8.49±1.92*^,##	11.42±1.70	7.29±0.87*
СAVI on right side	7.40±1.32^###	7.19±0.78	5.91±0.99*
СAVI on left side	7.22±1.32^###	7.2±1.1	5.98±0.87*

Notes: *P<0.001 in comparison with group 2; **P<0.033; ***P<0.003; ^#P<0.003 in comparison with control group; ^##P<0.008; ^###P<0.001.

Abbreviations: CAVI, cardio-ankle vascular index; PWVm, pulse wave velocity of muscular type arteries; PWVe, pulse wave velocity of elastic type arteries; AIx, augmentation index; AIx@75, augmentation index adjusted to heart rate 75; SBP, systolic blood pressure.

Table 3 Significant Correlation Between Arterial Stiffness and Other Parameters in Idiopathic Pulmonary Arterial Hypertension Patients

Parameters	Spearman Correlation Parameter, r, P	Multivariable Linear Regression Analysis β, P, CI
PWVe	PWVm: r=0.39, P=0.008	β=0.07, P=0.66 CI-0.25–0.39
	Uric acid: r=0.36, P=0.014	β=0.002, P=0.50 CI-0.004–0.007
PWVm	Uric acid: r=0.58, P<0.0001	β=0.009, P=0.001, CI 0.004–0.013
	NT-proBNP: r=0.33, P=0.03	β=0.12, P=0.79 CI-0.05–0.38
	Male gender: r=0.37, P=0.013	β=0.13, P=0.15 CI-0.44–2.67
CAVI right side	PWVe: r=0.30, P=0.042	β= 0.23, P=0.99 CI-0.24–0.24
	PWVm: r=0.44, P=0.003	β=0.16, P=0.08 CI-0.23–0.38
	Age: r=0.43, P=0.003	β=0.048, P=0.001, CI 0.021–0.076
	Uric acid: r=0.30, P=0.043	β=0.01, P=0.9 CI-0.003–0.004
	6MWT: r=−0.31, p=0.035	β=−0.002, P=0.33 CI-0.005–0.002
	TAPSE: r=−0.42, P=0.004	β=−0.13, P=0.014, CI-0.23- [- 0.027]
	NT-proBNP: r=0.37; P=0.015	β=0.001, P=0.25, CI-0.001–0.0001
CAVI left side	PWVm: r=0.37; P=0.012	β=0.073, P=0.43 CI-0.11–0.26
	Age: r=0.50; P=0.0005	β=0.052; P=0.001, CI 0.026–0.077
	6MWT: r=−0.45; P=0.002	β=−0.003, P=0.095 CI-0.006–0.001
	TAPSE: r=−0.45; P=0.002	β=−0.134, P=0.007, CI-0.23–[- 0.04]
	NT-proBNP: r=0.45; P=0.002	β=0.001, P=0.73 CI-0.17–0.18

Abbreviations: CAVI, cardio-ankle vascular index; PWVm, pulse wave velocity of muscular type arteries; PWVe, pulse wave velocity of elastic type arteries; TAPSE, tricuspid annular plane systolic excursion; 6MWT, 6-minute walk test distance; NT-pro BNP, N-terminal pro-B-type natriuretic peptide.

Table 4 Parameters Correlated Significantly with CAVI > 8.0 (Binary Logistic Analysis)

Parameters	Univariate Binary Logistic Analysis β, P, CI	Multivariable Binary Logistic Analysis β, P, CI
Age	1.107, P=0.002, CI 1.038–1.181	1.104, P=0.008, CI 1.026–1.189
6MWT	0.992, P=0.021, CI 0.986–0.999	0.99, P=0.18, CI 0.99–1.03
6MWT< 440 m	5.77, P=0.01, CI 1.52–21.93	3.09, P=0.15, CI 0.67–14.4
TAPSE	0.63, P=0.006, CI 0.454–0.877	0.66, P=0.016, CI 0.474–0.925

Abbreviations: CAVI, cardio-ankle vascular index; TAPSE, tricuspid annular plane systolic excursion; 6MWT, 6-minute walk test distance.