Reflection magnitude as a predictor of mortality: the multi-ethnic study of atherosclerosis
- Author
- Payman Zamani, David R Jacobs, Patrick Segers (UGent) , Daniel Duprez (UGent) , Lyndia Brumback, Richard A Kronmal, Scott M Lilly, Raymond R Townsend, Matthew Budoff, Joao A Lima, Peter Hannan and Julio Chirinos Medina (UGent)
- Organization
- Abstract
- Arterial wave reflections have been associated with mortality in an ethnically homogenous Asian population. It is unknown whether this association is present in a multiethnic population or whether it is independent of subclinical atherosclerosis. We hypothesized that reflection magnitude (defined as the ratio of the amplitude of the backward wave [P-b] to that of the forward wave [P-f]) is associated with all-cause mortality in a large multiethnic adult community-based sample. We studied 5984 participants enrolled in the Multi-Ethnic Study of Atherosclerosis who had analyzable arterial tonometry waveforms. During 9.8 +/- 1.7 years of follow-up, 617 deaths occurred, of which 134 (22%) were adjudicated cardiovascular deaths. In Cox proportional hazards models, each 10% increase in reflection magnitude was associated with a 31% increased risk for all-cause mortality (hazard ratio [HR]=1.31; 95% confidence interval [CI]=1.11-1.55; P=0.001). This relationship persisted after adjustment for various confounders and for markers of subclinical atherosclerosis (HR=1.23; 95% CI=1.01-1.51; P=0.04), including the coronary calcium score, ankle-brachial index, common carotid intima-media thickness, and ascending thoracic aortic Agatston score. P-b was independently associated with all-cause mortality in a similarly adjusted model (HR per 10 mm Hg increase in P-b =2.18; 95% CI=1.21-3.92; P=0.009). Reflection magnitude (HR=1.71; 95% CI=1.06-2.77; P=0.03) and P-b (HR=5.02; 95% CI=1.29-19.42; P=0.02) were mainly associated with cardiovascular mortality. In conclusion, reflection magnitude is independently associated with all-cause mortality in a multiethnic population initially free of clinically evident cardiovascular disease. This relationship persists after adjustment for a comprehensive set of markers of subclinical atherosclerosis.
- Keywords
- atherosclerosis, arteries, mortality, INCIDENT CARDIOVASCULAR EVENTS, LEFT-VENTRICULAR MASS, ANKLE-BRACHIAL INDEX, PRESSURE WAVE-FORM, ARTERIAL STIFFNESS, LOADING SEQUENCE, SYSTOLIC PRESSURE, RELAXATION, MESA, DISEASE
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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-5800587
- MLA
- Zamani, Payman, et al. “Reflection Magnitude as a Predictor of Mortality: The Multi-Ethnic Study of Atherosclerosis.” HYPERTENSION, vol. 64, no. 5, 2014, pp. 958–64, doi:10.1161/HYPERTENSIONAHA.114.03855.
- APA
- Zamani, P., Jacobs, D. R., Segers, P., Duprez, D., Brumback, L., Kronmal, R. A., … Chirinos Medina, J. (2014). Reflection magnitude as a predictor of mortality: the multi-ethnic study of atherosclerosis. HYPERTENSION, 64(5), 958–964. https://doi.org/10.1161/HYPERTENSIONAHA.114.03855
- Chicago author-date
- Zamani, Payman, David R Jacobs, Patrick Segers, Daniel Duprez, Lyndia Brumback, Richard A Kronmal, Scott M Lilly, et al. 2014. “Reflection Magnitude as a Predictor of Mortality: The Multi-Ethnic Study of Atherosclerosis.” HYPERTENSION 64 (5): 958–64. https://doi.org/10.1161/HYPERTENSIONAHA.114.03855.
- Chicago author-date (all authors)
- Zamani, Payman, David R Jacobs, Patrick Segers, Daniel Duprez, Lyndia Brumback, Richard A Kronmal, Scott M Lilly, Raymond R Townsend, Matthew Budoff, Joao A Lima, Peter Hannan, and Julio Chirinos Medina. 2014. “Reflection Magnitude as a Predictor of Mortality: The Multi-Ethnic Study of Atherosclerosis.” HYPERTENSION 64 (5): 958–964. doi:10.1161/HYPERTENSIONAHA.114.03855.
- Vancouver
- 1.Zamani P, Jacobs DR, Segers P, Duprez D, Brumback L, Kronmal RA, et al. Reflection magnitude as a predictor of mortality: the multi-ethnic study of atherosclerosis. HYPERTENSION. 2014;64(5):958–64.
- IEEE
- [1]P. Zamani et al., “Reflection magnitude as a predictor of mortality: the multi-ethnic study of atherosclerosis,” HYPERTENSION, vol. 64, no. 5, pp. 958–964, 2014.
@article{5800587, abstract = {{Arterial wave reflections have been associated with mortality in an ethnically homogenous Asian population. It is unknown whether this association is present in a multiethnic population or whether it is independent of subclinical atherosclerosis. We hypothesized that reflection magnitude (defined as the ratio of the amplitude of the backward wave [P-b] to that of the forward wave [P-f]) is associated with all-cause mortality in a large multiethnic adult community-based sample. We studied 5984 participants enrolled in the Multi-Ethnic Study of Atherosclerosis who had analyzable arterial tonometry waveforms. During 9.8 +/- 1.7 years of follow-up, 617 deaths occurred, of which 134 (22%) were adjudicated cardiovascular deaths. In Cox proportional hazards models, each 10% increase in reflection magnitude was associated with a 31% increased risk for all-cause mortality (hazard ratio [HR]=1.31; 95% confidence interval [CI]=1.11-1.55; P=0.001). This relationship persisted after adjustment for various confounders and for markers of subclinical atherosclerosis (HR=1.23; 95% CI=1.01-1.51; P=0.04), including the coronary calcium score, ankle-brachial index, common carotid intima-media thickness, and ascending thoracic aortic Agatston score. P-b was independently associated with all-cause mortality in a similarly adjusted model (HR per 10 mm Hg increase in P-b =2.18; 95% CI=1.21-3.92; P=0.009). Reflection magnitude (HR=1.71; 95% CI=1.06-2.77; P=0.03) and P-b (HR=5.02; 95% CI=1.29-19.42; P=0.02) were mainly associated with cardiovascular mortality. In conclusion, reflection magnitude is independently associated with all-cause mortality in a multiethnic population initially free of clinically evident cardiovascular disease. This relationship persists after adjustment for a comprehensive set of markers of subclinical atherosclerosis.}}, author = {{Zamani, Payman and Jacobs, David R and Segers, Patrick and Duprez, Daniel and Brumback, Lyndia and Kronmal, Richard A and Lilly, Scott M and Townsend, Raymond R and Budoff, Matthew and Lima, Joao A and Hannan, Peter and Chirinos Medina, Julio}}, issn = {{0194-911X}}, journal = {{HYPERTENSION}}, keywords = {{atherosclerosis,arteries,mortality,INCIDENT CARDIOVASCULAR EVENTS,LEFT-VENTRICULAR MASS,ANKLE-BRACHIAL INDEX,PRESSURE WAVE-FORM,ARTERIAL STIFFNESS,LOADING SEQUENCE,SYSTOLIC PRESSURE,RELAXATION,MESA,DISEASE}}, language = {{eng}}, number = {{5}}, pages = {{958--964}}, title = {{Reflection magnitude as a predictor of mortality: the multi-ethnic study of atherosclerosis}}, url = {{http://doi.org/10.1161/HYPERTENSIONAHA.114.03855}}, volume = {{64}}, year = {{2014}}, }
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