title: Presystolic A wave may predict increased arterial stiffness in asymptomatic individuals.
abstract: BACKGROUND
  Stiffness of large arteries has been related to cardiovascular mortality. The cardioankle vascular index (CAVI) is a novel parameter of arterial stiffness. The main aim of the present study was to investigate the association between presystolic wave (PSW) on left ventricular outflow tract (LVOT) and CAVI.
  
  
  METHODS
  Patients admitted to the cardiology outpatient clinic were consecutively enrolled. Arterial stiffness was assessed by the CAVI. It was measured using a VaSera VS-1000 CAVI instrument. Pulse Doppler flow evaluation in LVOT was performed just proximal to the aortic valve in an apical five-chamber view. The presence of a PSW preceding the LVOT flow was assessed in all patients.
  
  
  RESULTS
  A total of 200 patients were enrolled consecutively. Patients with PSW had higher CAVI values compared with those without PSW (8.6±1.6 vs. 7.3±1.5). There was a significant correlation between PSW velocity and CAVI (r=0.34, P<0.001). Analysis using the receiver operating characteristics curve showed that PSW velocity of 61 cm/s constitutes the cutoff value for abnormal CAVI (CAVI≥9) with 75% sensitivity and 74% specificity (area under the curve: 0.883, 95% confidence interval: 0.694-0.972).
  
  
  CONCLUSIONS
  Assessment of presystolic A wave on echocardiography examination may provide important information on the vascular function, which has a prognostic impact.
authors.affiliation: aDepartment of Cardiology, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital bDepartment of Cardiology, Akcaabat Haçkali Baba State Hospital, Trabzon, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Korkmaz
authors.forename: Ali R
authors.initials: AR
authors.lastname: Akyüz
authors.forename: Ismail
authors.initials: I
authors.lastname: Gurbak
authors.forename: Hakan
authors.initials: H
authors.lastname: Erkan
authors.forename: Ihsan
authors.initials: I
authors.lastname: Dursun
authors.forename: Sukru
authors.initials: S
authors.lastname: Celik
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness