Noninvasive brachial-ankle pulse wave velocity in hypertensive patients with left ventricular hypertrophy.
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.
Park
Kyoung-Ha
KH
Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Seoul, Korea. pkhmd@naver.com
Park
Woo Jung
WJ
Kim
Min-Kyu
MK
Jung
Jae-Hun
JH
Choi
Seonghoon
S
Cho
Jung Rae
JR
Kim
Hyun-Sook
HS
Lee
Namho
N
Cho
Goo-Yeong
GY
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