title: Elevated brachial-ankle pulse wave velocity is associated with left ventricular hypertrophy in hypertensive patients after stroke.
abstract: Brachial-ankle pulse wave velocity (baPWV) is widely used as a marker of arterial stiffness, but there are no data regarding the usefulness of measuring baPWV in hypertensive patients after stroke. The purpose of this study was to examine the clinical significance of baPWV by assessing its correlation with echocardiographic parameters in hypertensive patients after stroke. The study enrolled 61 hypertensives after stroke (24 patients with cerebral infarction and 37 with cerebral hemorrhage) and 61 age-matched hypertensives without stroke. Left ventricular (LV) hypertrophy was evaluated by measuring LV mass index (LVMI) and relative wall thickness (RWT), and LV diastolic function was evaluated by measuring peak early mitral annular velocities (E') using echocardiography. Concentric LV hypertrophy showing increased RWT (0.50 +/- 0.12) was observed in hypertensives after stroke, but not in hypertensives without stroke. In hypertensives after stroke, elevated baPWV correlated with age (r = 0.60, p < 0.001), systolic blood pressure (r = 0.56, p < 0.001), increased LVMI (r = 0.47, p < 0.001), and decreased E' (r = -0.40, p = 0.002). Multiple regression analysis showed that age (beta coefficient = 0.43, p < 0.001), systolic blood pressure (beta coefficient = 0.40, p < 0.001), and LVMI (beta coefficient = 0.25, p = 0.008) were independent determinants of elevated baPWV. In conclusion, elevated baPWV is more closely associated with LV hypertrophy than with LV diastolic dysfunction. Elevated baPWV is independently associated with the severity of LV hypertrophy adjusted with systolic blood pressure and age in hypertensive patients after stroke.
authors.affiliation: Department of Integrated Medicine, Kagawa University, Kagawa, Japan. masugata@med.kagawa-u.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Masugata
authors.forename: Shoichi
authors.initials: S
authors.lastname: Senda
authors.forename: Jun
authors.initials: J
authors.lastname: Hoshikawa
authors.forename: Koji
authors.initials: K
authors.lastname: Murao
authors.forename: Naohisa
authors.initials: N
authors.lastname: Hosomi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okuyama
authors.forename: Michio
authors.initials: M
authors.lastname: Inukai
authors.forename: Takashi
authors.initials: T
authors.lastname: Himoto
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakatsuka
authors.forename: Masanobu
authors.initials: M
authors.lastname: Imai
authors.forename: Takahisa
authors.initials: T
authors.lastname: Noma
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kohno
authors.forename: Fuminori
authors.initials: F
authors.lastname: Goda
mesh_terms: D000368:Aged; D000842:Ankle / Q000098:blood supply*; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology; D001916:Brachial Artery / Q000502:physiology* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow / Q000502:physiology; D011674:Pulse; D020521:Stroke / Q000503:physiopathology*