title: Brachial-ankle pulse wave velocity as an early indicator of left ventricular diastolic function among hypertensive subjects.
abstract: While increased arterial stiffness is a known risk of cardiovascular disease, pulse wave velocity (PWV) is a conventionally adopted index of arterial stiffness. However, the relationship between PWV and left ventricular functions are not thoroughly evaluated. This cross-sectional study investigated whether PWV measurement is an early indicator of left ventricular (LV) dysfunction. A noninvasive, volume-plethysmographic apparatus was used to determine blood pressure, electrocardiogram, heart sounds, and PWV in 42 consecutively diagnosed subjects with hypertension, and 42 sex- and age-matched nonhypertension subjects were studied. Arterial stiffness and aortic stiffness were evaluated by brachial-ankle (b-a) PWV, heart-carotid (h-c) PWV, heart-femoral (h-f) PWV, carotid-femoral (c-f) PWV, and femoral-ankle (f-a) PWV. Function of LV was estimated by tissue Doppler imaging (TDI) echocardiography. Hypertension subjects exhibited higher b-a PWV and late diastolic mitral flow velocity values than those of nonhypertensive subjects. Pearson correlation analysis revealed that LV diastolic function (Em(av)) negatively correlated with c-f PWV and b-a PWV. Multiple linear regression analysis indicated that b-a PWV was independently and negatively associated with LV diastolic function (Em(av)). Further analysis by stratified hypertensive status, the b-a PWV were independently and negatively associated with Em(av) in hypertensive subjects (p = 0.004) only. In conclusion, the b-a PWV, but not c-f PWV, h-c PWV, h-f PWV, or f-a PWV, is significantly correlated with LV diastolic function in hypertensive subjects, indicating that b-a PWV involving both central and peripheral components of arterial stiffness may be an early indicator of LV dysfunction.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Chao-Ping
authors.initials: CP
authors.lastname: Wang
authors.forename: Wei-Chin
authors.initials: WC
authors.lastname: Hung
authors.forename: Teng-Hung
authors.initials: TH
authors.lastname: Yu
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Hsu
authors.forename: Yen-Hsun
authors.initials: YH
authors.lastname: Chen
authors.forename: Cheng-An
authors.initials: CA
authors.lastname: Chiu
authors.forename: Li-Fen
authors.initials: LF
authors.lastname: Lu
authors.forename: Fu-Mei
authors.initials: FM
authors.lastname: Chung
authors.forename: Ya-Ai
authors.initials: YA
authors.lastname: Cheng
authors.forename: Yau-Jiunn
authors.initials: YJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003971:Diastole; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D018617:Ultrasonography, Doppler, Pulsed; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*