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Open AccessArticle

Impact of Simultaneous Consideration of Cardiac and Vascular Function on Long-Term All-Cause and Cardiovascular Mortality

1
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
2
Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
3
Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 812, Taiwan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(12), 2145; https://doi.org/10.3390/jcm8122145
Received: 16 October 2019 / Revised: 2 December 2019 / Accepted: 3 December 2019 / Published: 4 December 2019
(This article belongs to the Section Cardiology)
Background: Left ventricular ejection fraction (LVEF) is a good indicator of cardiac function, and brachial-ankle pulse wave velocity (baPWV) is a good indicator of vascular function. Both of them can predict cardiovascular (CV) outcomes. Objectives: There is scarce literature discussing the impact of simultaneous consideration of cardiac and vascular function on overall and CV mortality. Methods: We included 958 patients and classified them into four groups. Groups 1 to 4 were patients with LVEF ≥ 50% and baPWV below the median, LVEF < 50% but baPWV below the median, LVEF ≥ 50% but baPWV above the median, and LVEF < 50% and baPWV above the median, respectively. Results: The median follow-up to mortality was 93 (25th–75th percentile: 69–101) months. There were 91 cases of CV mortality and 238 cases of all-cause mortality. After multivariable analysis, age, gender, diabetes, mean blood pressure, group 2 versus group 1, and group 4 versus group 1 were significant predictors of all-cause mortality (<i>P</i> ≤ 0.038) and age, diabetes, mean blood pressure, group 2 versus group 1, and group 4 versus group 1 were significant predictors of CV mortality (<i>P</i> ≤ 0.008). Conclusions: Patients with higher LVEF and lower baPWV had a similar overall and CV mortality as patients with higher LVEF and baPWV. Patients with lower LVEF and higher baPWV had the highest overall and CV mortality among the four study groups. In addition, patients with lower LVEF alone had a higher CV mortality than the patients with higher baPWV alone. Therefore, simultaneous consideration of cardiac and vascular function may be useful in predicting overall and CV mortality.
Keywords: all-cause mortality; arterial stiffness; cardiovascular mortality; left ventricular systolic function; pulse wave velocity all-cause mortality; arterial stiffness; cardiovascular mortality; left ventricular systolic function; pulse wave velocity
MDPI and ACS Style

Hsu, P.-C.; Lee, W.-H.; Tsai, W.-C.; Chu, C.-Y.; Chen, Y.-C.; Lee, M.-K.; Lin, T.-H.; Lee, C.-S.; Voon, W.-C.; Lai, W.-T.; Sheu, S.-H.; Su, H.-M. Impact of Simultaneous Consideration of Cardiac and Vascular Function on Long-Term All-Cause and Cardiovascular Mortality. J. Clin. Med. 2019, 8, 2145.

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