Reservoir-wave parameters and cardiovascular prediction: Analysis of the population-based CARTaGENE cohort

Description

Background:
The reservoir-wave concept hypothesizes that blood pressure is the sum of a reservoir and an excess pressure.
Nevertheless, the clinical association of reservoir-wave parameters with cardiovascular outcomes remains controversial.

Methods:
We studied individuals aged between 40 and 69 from the CARTaGENE cohort (Canada). Radial waveforms were measured with
aplanation tonometry (SphygmoCor). They were transformed to central waveforms using generalized transfer functions and used to generate reservoir parameters (Reservoir pressure [RP], Reservoir pressure integral [RPI], Excess pressure [XSP], Excess pressure integral [XSPI],
Systolic rate constant [SC], Diastolic rate constant [DC], Optimized asymptotic pressure [PInf]). Major adverse atherosclerotic events (MACE: cardiovascular death, stroke, myocardial infarction) during a 10-year follow-up were obtained using medico-administrative databases. Associations of reservoir parameters with MACE were derived using crude and fully adjusted Cox models. Incremental predictive performance over the ASCVD score (atherosclerotic cardiovascular disease score; using revised pooled cohort equations) for each reservoir parameter was displayed using c-statistic improvement and continuous net reclassifcation indexes (NRI).

Results:
From 17,629 individuals, 2327 had a MACE during the follow-up. All reservoir parameters were signifcantly higher in patients
who experienced a MACE. After full adjustment, RP, XSPI and DC
were associated with increased MACE incidence (Table). Spline analysis did not reveal any non-linear relationships between reservoir parameters and MACEs. When added to the ASCVD prediction score, XSP and DC signifcantly improved c-statistics while RP, XSPI, DC and PInf led to a signifcant net reclassifcation improvement.

Conclusion:
Reservoir parameters, especially the diastolic rate constant, improve cardiovascular prediction in a population-based cohort.

Period	21 Oct 2022
Event title	Artery 22
Event type	Other
Location	Nancy, FranceShow on map
Degree of Recognition	International