Impact of systolic time intervals on the relationship between arterial stiffness and left ventricular hypertrophy.
OBJECTIVE
Arterial stiffness is correlated with left ventricular hypertrophy (LVH) and is susceptible to left ventricular performance. Therefore, if left ventricular systolic function is unknown, the relationship between arterial stiffness and LVH is controversial. This study was to assess the impact of the ratio of brachial pre-ejection period (bPEP) to brachial ejection time (bET), a marker of left ventricular systolic function, on the relationship between brachial-ankle pulse wave velocity (baPWV) and LVH.


METHODS
A total of 1146 patients were included in the study. The baPWV and bPEP/bET were measured using an ABI-form device. Patients were classified into four groups. Groups 1, 2, 3, and 4 were patients with bPEP/bET ≤ 0.38 and baPWV below the median, bPEP/bET > 0.38 but baPWV below the median, bPET/bET ≤ 0.38 but baPWV above the median, and bPET/bET > 0.38 and baPWV above the median, respectively.


RESULTS
Patients in groups 3 and 4 (high baPWV) and patients in group 2 (low baPWV but high bPEP/bET) were associated with increased left ventricular mass index (LVMI) and LVH (all P < 0.001). In a multivariate model, baPWV was significantly associated with LVMI (P = 0.007) and LVH (P = 0.025). Further adjustment for bPEP/bET made the association between baPWV and LVMI (P = 0.150) and LVH (P = 0.173) disappear.


CONCLUSIONS
The bPEP/bET has an important impact on the relationship between baPWV and LVH. Therefore, the value of bPEP/bET obtained from the same examination should be considered while interpreting the relationship between baPWV and LVH.
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan.
Ho-Ming
HM
Su
Tsung-Hsien
TH
Lin
Po-Chao
PC
Hsu
Chun-Yuan
CY
Chu
Wen-Hsien
WH
Lee
Szu-Chia
SC
Chen
Chee-Siong
CS
Lee
Wen-Chol
WC
Voon
Wen-Ter
WT
Lai
Sheng-Hsiung
SH
Sheu
D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000503:physiopathology*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011673:Pulsatile Flow; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013599:Systole; D013624:Taiwan; D013997:Time Factors; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology*; D016277:Ventricular Function, Left