Associations of Brachial-Ankle Pulse Wave Velocity With Left Ventricular Geometry and Diastolic Function in Untreated Hypertensive Patients

Abstract

Background: Although brachial-ankle pulse wave velocity (baPWV) is simple and convenient, its usefulness as an initial screening test for hypertensive patients is not well-known. This study aimed to investigate the association of baPWV with left ventricular (LV) geometry and diastolic function in treatment-naive hypertensive patients.Methods: A total of 202 untreated hypertensive patients (mean age, 62 years; males, 51.5%) without documented cardiovascular diseases were prospectively enrolled. Both baPWV and transthoracic echocardiography were performed on the same day before antihypertensive treatment.Results: In multiple linear regression analysis after adjustment for potential confounders, baPWV had significant correlations with structural measurements of LV including relative wall thickness (β = 0.219, P = 0.021) and LV mass index (β = 0.286, P = 0.002), and four diastolic parameters including septal e′ velocity (β = −0.199, P = 0.018), E/e′ (β = 0.373, P < 0.001), left atrial volume index (β = 0.334, P < 0.001), and maximal velocity of tricuspid regurgitation (β = 0.401, P < 0.001). The baPWV was significantly increased in patients with LV hypertrophy, abnormal LV remodeling, or diastolic dysfunction, compared to those without (P = 0.008, P = 0.035, and P < 0.001, respectively). In the receiver operating characteristic curve analysis, the discriminant ability of baPWV in predicting LV hypertrophy and diastolic dysfunction had an area under the curve of 0.646 (95% confidence interval 0.544–0.703, P = 0.004) and 0.734 (95% confidence interval 0.648–0.800, P < 0.001), respectively.Conclusion: baPWV was associated with parameters of LV remodeling and diastolic function in untreated hypertensive patients. The baPWV could be a useful screening tool for the early detection of adverse cardiac features among untreated hypertensive patients.

Sex-specific associations of brachial–ankle pulse wave velocity with adverse cardiac remodeling and long-term cardiovascular outcome

“…The stiffened artery losses its ability to buffer the high pulsatile pressure, which propagates backward more rapidly to LV, resulting in the increased cardiac afterload and decreased coronary blood flow [34]. Previous studies have demonstrated that baPWV has a significant association with the prevalence of LVH, increased LV filling pressure, and impaired systolic and diastolic function [2][3][4][5][6], suggesting its role as a surrogate marker for preclinical cardiac damage. Importantly, these associations have been reported to be stronger in women than in men [5,6,20].…”

“…A rterial stiffness progresses with age [1]. Stiffened arteries increase cardiac afterload and decrease coronary blood flow, resulting in adverse structural and functional cardiac remodeling [2][3][4][5][6]. Multiple studies have shown that arterial stiffness is significantly associated with the burden of cardiovascular risk factors and also highly predictive of adverse cardiovascular events [7,8].…”

Association between body fat parameters and arterial stiffness

“…The baPWV was automatically generated using a VP-1000 analyzer (Collin Co., Komaki, Japan) 24 , 25 . Measurement of baPWV was performed in an isolated room with constant temperature and humidity in the morning.…”

Comparison of the Association Between Arterial Stiffness Indices and Heart Failure in Patients With High Cardiovascular Risk: A Retrospective Study

“…However, a recent study on the relationship of baPWV with LV remodelling and diastolic dysfunction was published. In 202 untreated hypertensive patients, baPWV was significantly associated with parameters of LV remodelling and diastolic function, and it predicted diastolic dysfunction well ( 23 ). Although this study did not examine the association of baPWV with HF, it suggests that baPWV contributes to the development of HF, as LV remodelling and diastolic dysfunction in hypertensive patients are considered to be the first steps leading to HF.…”