title: Association of increased arterial stiffness and p wave dispersion with left ventricular diastolic dysfunction.
abstract: BACKGROUND
  The association between increased arterial stiffness and left ventricular diastolic dysfunction (LVDD) may be influenced by left ventricular performance. P wave dispersion is not only a significant determinant of left ventricular performance, but is also correlated with LVDD. This study is designed to compare left ventricular diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV) and corrected P wave dispersion (PWDC) and assess whether the combination of baPWV and PWDC can predict LVDD more accurately.
  
  
  METHODS
  This cross-sectional study enrolled 270 patients and classified them into four groups according to the median values of baPWV and PWDC. LVDD was defined as impaired relaxation and pseudonormal/restrictive mitral inflow patterns.
  
  
  RESULTS
  The ratio of transmitral E wave velocity to early diastolic mitral annulus velocity (E/Ea) was higher in group with higher baPWV and PWDC than in the other groups (all p <0.001). The prevalence of LVDD was higher in group with higher baPWV and PWDC than in the two groups with lower baPWV (p ≤ 0.001). The baPWV and PWDC were correlated with E/Ea and LVDD in multivariate analysis (p ≤ 0.030). The addition of baPWV and PWDC to a clinical mode could significantly improve the R square in prediction of E/Ea and C statistic and integrated discrimination index in prediction of LVDD (p ≤ 0.010).
  
  
  CONCLUSIONS
  This study showed increased baPWV and PWDC were correlated with high E/Ea and LVDD. The addition of baPWV and PWDC to a clinical model improved the prediction of high E/Ea and LVDD. Screening patients by means of baPWV and PWDC might help identify the high risk group of elevated left ventricular filling pressure and LVDD.
authors.affiliation: 1. Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 2. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;
authors.forename: Wei-Chung
authors.initials: WC
authors.lastname: Tsai
authors.forename: Kun-Tai
authors.initials: KT
authors.lastname: Lee
authors.forename: Hsuan-Fu
authors.initials: HF
authors.lastname: Kuo
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Tang
authors.forename: Shih-Jie
authors.initials: SJ
authors.lastname: Jhuo
authors.forename: Chih-Sheng
authors.initials: CS
authors.lastname: Chu
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.forename: Po-Chao
authors.initials: PC
authors.lastname: Hsu
authors.forename: Ming-Yen
authors.initials: MY
authors.lastname: Lin
authors.forename: Feng-Hsien
authors.initials: FH
authors.lastname: Lin
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Wen-Chol
authors.initials: WC
authors.lastname: Voon
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
mesh_terms: D000328:Adult; D001158:Arteries / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059289:Vascular Stiffness / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
keywords: P wave dispersion; brachial-ankle pulse wave velocity; left ventricular diastolic dysfunction.
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