title: The clinical usefulness of central hemodynamics to evaluate diastolic dysfunction in subjects without hypertension.
abstract: OBJECTIVE
  Diastolic dysfunction is associated with increased arterial stiffness in patients with hypertension. However, the role of arterial stiffness in diastolic dysfunction in subjects without hypertension has not been fully established.
  
  
  METHODS
  A total of 287 subjects (male:female ratio 121:166, mean age 53.0±14.4 years) without hypertension or any heart disease who simultaneously received transthoracic echocardiography and noninvasively semiautomated radial artery applanation tonometry (with an Omron HEM-9000AI) in the Department of Internal Medicine, St Vincent's Hospital, from July 2011 to September 2012, were enrolled in this study.
  
  
  RESULTS
  A total of 147 subjects (male:female ratio 59:88, mean age 61.7±9.9 years), representing 51.2% of the 287 subjects, had diastolic dysfunction (defined as abnormal relaxation pattern of mitral inflow). There were significant differences in systolic blood pressure (BP), pulse pressure, late systolic peak pressure (SBP2), and radial augmentation index (RaAIx) between normal diastolic function and diastolic dysfunction. ΔBP was defined as systolic BP minus SBP2, because of the difference in systolic BP between the two groups. ΔBP (odds ratio [OR] 1.059, 95% confidence interval [CI] 1.005-1.115; P=0.032) and RaAIx (odds ratio 1.027, 95% CI 1.009-1.044, P=0.003) were associated with diastolic dysfunction. A receiver operating-characteristic curve showed that ΔBP (area under the curve 0.875, 95% CI 0.832-0.911) and RaAIx (area under the curve 0.878, 95% CI 0.835-0.914) were associated with diastolic dysfunction.
  
  
  CONCLUSIONS
  We found that ΔBP and increased RaAIx were associated with diastolic dysfunction in subjects without hypertension after adjustment for age and sex. Therefore, it is suggested that noninvasive estimation of central BP may be useful to reflect diastolic dysfunction in subjects with normal peripheral BP.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, Catholic University of Korea, Suwon, South Korea.
authors.forename: Geehee
authors.initials: G
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, Catholic University of Korea, Suwon, South Korea.
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, Catholic University of Korea, Suwon, South Korea.
authors.forename: Keon-Woong
authors.initials: KW
authors.lastname: Moon
authors.affiliation: Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, Catholic University of Korea, Suwon, South Korea.
authors.forename: Ki-Dong
authors.initials: KD
authors.lastname: Yoo
authors.affiliation: Division of Cardiology, Department of Internal Medicine, School of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Sang-Hyun
authors.initials: SH
authors.lastname: Ihm
authors.affiliation: Division of Cardiology, Department of Internal Medicine, School of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Youn
authors.affiliation: Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, Catholic University of Korea, Suwon, South Korea.
authors.forename: Chul-Min
authors.initials: CM
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D005260:Female; D054144:Heart Failure, Diastolic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D017534:Radial Artery / Q000503:physiopathology; D012737:Sex Factors
keywords: augmentation index; central blood pressure; diastolic dysfunction
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