Intrinsic Frequencies of Carotid Pressure Waveforms Predict Heart Failure Events
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.
© 2020 The Authors. Hypertension is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial-NoDerivs License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited, the use is noncommercial, and no modifications or adaptations are made. Received July 16, 2020; accepted December 5, 2020. Originally published 4 Jan 2021. From the Framingham Heart Study of the National Heart Lung and Blood Institute of the National Institutes of Health and Boston University School of Medicine. This work was supported by the National Heart, Lung and Blood Institute's Framingham Heart Study (Contracts No. N01-HC-25195 and HHSN268201500001I) and by HL076784, AG028321, HL070100, HL060040, HL080124, HL071039, HL077447, HL107385, HL126136, HL128914, and 2-K24-HL04334. G.F. Mitchell is owner of Cardiovascular Engineering, Inc, a company that develops and manufactures devices to measure vascular stiffness, serves as a consultant to and receives honoraria from Novartis, Merck, Servier and Philips, and was funded by research grants HL094898, DK082447, HL107385, HL104184, and HL126136 from the National Institutes of Health. N.M. Pahlevan holds equity and has a consulting agreement with Avicena LLC. D.G. Rinderknecht is the Chief Technology Officer for Avicena, LLC. The other authors report no conflicts.
Published - HYPERTENSIONAHA.120.15632.pdf
Supplemental Material - hyp_hype-2020-15632-t_supp2.pdf