title: Noninvasive brachial-ankle pulse wave velocity in hypertensive patients with left ventricular hypertrophy.
abstract: BACKGROUND
  The elevation of left ventricular filling pressure (LVFP) could be an important prognostic factor in patients with hypertension. We hypothesized that noninvasive brachial-ankle pulse wave velocity (baPWV) is associated with increased LVFP in hypertensive patients with LV hypertrophy (LVH).
  
  
  METHODS
  We enrolled patients with well-controlled hypertension for more than 1 year with LV ejection fraction (LVEF) > or = 55%, and LVH. The relationship between Doppler echocardiographic parameters of LVFP and baPWV with B-type natriuretic peptide (BNP) was also evaluated.
  
  
  RESULTS
  A total of 62 patients were enrolled (31 patients with E/E(a) >15 and 31 patients with E/Ea < or = 15) and the baPWV of the E/Ea >15 group was significantly increased compared to the E/Ea < or = 15 group (1,664.3 +/- 270.5 vs. 1,381.9 +/- 159.1 cm/s, P < 0.01). The baPWV showed better correlation with E/Ea (r = 0.69, P < 0.01) than the BNP (r = 0.47, P < 0.01). A multivariate linear regression model showed that only baPWV was significantly correlated with E/E(a), and that the association was independent of other factors. The area under the receiver-operating characteristic (ROC) curve of baPWV for the detection of elevated LVFP (E/Ea >15) was 0.79 (P < 0.01) and the optimal cutoff point of 1,440 cm/s produced 75% sensitivity and 62% specificity (the positive and negative predictive values were 68 and 71%, respectively).
  
  
  CONCLUSIONS
  In this study, we have demonstrated that elevated baPWV is associated with noninvasive markers of increased LVFP in hypertensive LVH patients with preserved LV systolic function.
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Seoul, Korea. pkhmd@naver.com
authors.forename: Kyoung-Ha
authors.initials: KH
authors.lastname: Park
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Park
authors.forename: Min-Kyu
authors.initials: MK
authors.lastname: Kim
authors.forename: Jae-Hun
authors.initials: JH
authors.lastname: Jung
authors.forename: Seonghoon
authors.initials: S
authors.lastname: Choi
authors.forename: Jung Rae
authors.initials: JR
authors.lastname: Cho
authors.forename: Hyun-Sook
authors.initials: HS
authors.lastname: Kim
authors.forename: Namho
authors.initials: N
authors.lastname: Lee
authors.forename: Goo-Yeong
authors.initials: GY
authors.lastname: Cho
mesh_terms: D000368:Aged; D000842:Ankle; D055109:Ankle Brachial Index / Q000379:methods*; D001916:Brachial Artery / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D013318:Stroke Volume; D013599:Systole