Quantification of aortic stiffness to predict the degree of left ventricular diastolic function.
BACKGROUND
The association between the arterial stiffness and the severity of left ventricular (LV) diastolic function in hypertension has not been fully evaluated. This study was conducted to evaluate the relationship of aortic stiffness by brachial-ankle pulse wave velocity (baPWV) to parameters reflecting the atherosclerosis and the severity of LV diastolic function in patients with hypertension.


METHODS
LV ejection fraction, the ratio of peak velocity of early rapid filling and peak velocity of atrial filling (E/A ratio) and LV mass index were determined with echocardiography in 800 patients with hypertension. LV diastolic function was estimated by pulsed-tissue Doppler imaging (TDI) echocardiography, averaging diastolic mitral annular velocity measurements (Emav, Amav and Emav/Amav ratio) from 2 separate sites (basal septal and lateral). The baPWV was measured by the volume rendering method.


RESULTS
Stepwise multiple logistic regression analysis demonstrated that the independent factors of LV diastolic function were deceleration time, baPWV, age and Emav/Amav ratio. The receiver- operator characteristic curve demonstrated a baPWV of 1566 cm/sec was useful to discriminate mild LV diastolic dysfunction (sensitivity, 78%; specificity, 78%), and that a baPWV of 1730 cm/sec was useful to discriminate moderate LV diastolic dysfunction (sensitivity, 73%; specificity, 57%).


CONCLUSIONS
Increased baPWV relates not only to the parameters reflecting atherosclerosis but also to those reflecting LV diastolic dysfunction. TDI-detected LV diastolic dysfunction is accompanied by increased aortic stiffness in essential hypertension. Therefore, quantification of aortic stiffness can predict the degree of LV diastolic function.
Chung
Chang-Min
CM
Division of Cardiology, Chiayi Chang Gung Memorial Hospital, Chia Yi Hsien, Taiwan. cmchung02@hotmail.com/accept@adm.cgmh.org.tw
Chu
Chi-Ming
CM
Chang
Shih-Tai
ST
Cheng
Hui-Wen
HW
Yang
Teng-Yao
TY
Wan
Po-Chang
PC
Pan
Kuo-Li
KL
Lin
Yu-Sheng
YS
Hsu
Jen-Te
JT
D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001011:Aorta / Q000503:physiopathology*; D015331:Cohort Studies; D003971:Diastole; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left