title: Associations of pulse pressure index with left ventricular filling pressure and diastolic dysfunction in patients with chronic kidney disease.
abstract: BACKGROUND
  Patients with chronic kidney disease (CKD) often have poor vascular compliance and poor left ventricular diastolic dysfunction (LVDD). The pulse pressure index (PPI) defined as ((systolic blood pressure - diastolic blood pressure)/systolic blood pressure) reflects vascular compliance. Vascular compliance is reportedly associated with left ventricular diastolic function. This study of CKD patients investigated whether PPI correlates with the ratio of transmitral E wave velocity (E) to early diastole mitral annulus velocity (Ea) or with LVDD.
  
  
  METHODS
  This study enrolled 511 CKD patients who had been referred for echocardiographic examination. Blood pressure was automatically measured with an ABI-form device. The LVDD was defined as E-to-transmitral A wave velocity ratio of ≥0.9, Ea <8 cm/s, or E/Ea ≥15.
  
  
  RESULTS
  Compared with those with E/Ea <15, patients with E/Ea ≥15 had significantly higher systolic blood pressure, pulse pressure, and PPI (all P < 0.001). Multivariable analysis showed that PPI was independently associated with E/Ea (unstandardized coefficient β = 1.348; P < 0.001) and with LVDD (odds ratio = 1.441 per 0.064 increase; P < 0.001).
  
  
  CONCLUSIONS
  This study showed that increased PPI significantly correlates with elevated E/Ea and LVDD in CKD patients. Because PPI can be rapidly acquired during blood pressure measurement, it may be helpful for identifying CKD patients with a high left ventricular filling pressure and LVDD.
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Wen-Hsien
authors: WH
authors: Lee
authors: Po-Chao
authors: PC
authors: Hsu
authors: Chun-Yuan
authors: CY
authors: Chu
authors: Szu-Chia
authors: SC
authors: Chen
authors: Ho-Ming
authors: HM
authors: Su
authors: Tsung-Hsien
authors: TH
authors: Lin
authors: Chee-Siong
authors: CS
authors: Lee
authors: Hsueh-Wei
authors: HW
authors: Yen
authors: Wen-Chol
authors: WC
authors: Voon
authors: Wen-Ter
authors: WT
authors: Lai
authors: Sheng-Hsiung
authors: SH
authors: Sheu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001794:Blood Pressure; D016009:Chi-Square Distribution; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012307:Risk Factors; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left; D017725:Ventricular Pressure
keywords: blood pressure; chronic kidney disease; hypertension; left ventricular diastolic dysfunction; left ventricular filling pressure; pulse pressure; pulse pressure index.