Total Brachial Artery Reactivity and Incident Heart Failure and Heart Failure Sub-Types: Multi-Ethnic Study of Atherosclerosis
Brooks College of Health
Master of Science in Health Science (MSH)
Clinical & Applied Movement Sciences
NACO controlled Corporate Body
University of North Florida. Department of Clinical & Applied Movement Sciences
Dr. James R. Churilla
Dr. Michael R. Richardson
Dr. Jasper Xu
Dr. Hirofumi Tanaka
Dr. Kevin S. Heffernan
Dr. Joel Beam
Dr. Curt Lox
Purpose: The aim of this study was to evaluate the association between total brachial artery reactivity (TBAR) and the cumulative risk of incident heart failure (HF), HF with reduced ejection fraction (HFrEF), and HF with preserved ejection fraction (HFpEF) in a community-based study. Methods: Sample included 5,499 participants (45-84 years of age) from the Multi-Ethnic Study of Atherosclerosis who were free of cardiovascular disease at baseline. Brachial artery ultrasound was performed after five minutes of cuff occlusion at the right forearm. TBAR was calculated as the difference between maximum and minimum brachial artery diameters following cuff release, divided by the minimum diameter multiplied by 100%. A dichotomous TBAR variable was created based on the median value (below or above 7.9%). Participants with EF≤40% were considered HFrEF and those with EF ≥ 50% were considered HFpEF. Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results: Over a mean follow-up period of 12.5 years, incident HF was diagnosed in 250 participants; 98 classified as HFrEF, 106 as HFpEF, and 46 with unknown or borderline EF (41-49%). Crude analysis revealed that those with TBAR below the median have significantly higher risk of HF (HR 1.46; 95% CI 1.13-1.88, pConclusion:Lower TBAR values were associated with higher rates of incident HF and HFrEF, suggesting a possible role of endothelial dysfunction in HF pathogenesis. The impact of other known HF risk factors may mediate this relationship, thus further research is warranted.
Charry Segura, Daniela, "Total Brachial Artery Reactivity and Incident Heart Failure and Heart Failure Sub-Types: Multi-Ethnic Study of Atherosclerosis" (2021). UNF Graduate Theses and Dissertations. 1008.