Impact of a systolic parameter, defined as the ratio of right brachial pre-ejection period to ejection time, on the relationship between brachial-ankle pulse wave velocity and left ventricular diastolic function

Hsu, Po-Chao; Lin, Tsung-Hsien; Lee, Chee-Siong; Chu, Chun-Yuan; Su, Ho‐Ming; Voon, Wen‐Chol; Lai, Wen‐Ter; Sheu, Sheng‐Hsiung

doi:10.1038/hr.2010.262

Cited by 12 publications

(8 citation statements)

References 33 publications

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“…However, a reducing LV ejection velocity may decrease the PWV. Weber et al [8] and our recent studies [9]–[10] found LV performance could influence the PWV. Left ventricular hypertrophy (LVH) is a significant determinant of impaired LV performance [11].…”

Section: Introductionmentioning

confidence: 61%

Association of Arterial Stiffness and Electrocardiography-Determined Left Ventricular Hypertrophy with Left Ventricular Diastolic Dysfunction

et al. 2012

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ObjectivesIncreased arterial stiffness is associated with left ventricular diastolic dysfunction (LVDD), but this association may be influenced by left ventricular (LV) performance. Left ventricular hypertrophy (LVH) is not only a significant determinant of LV performance, but is also correlated with LVDD. This study is designed to compare LV diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV) and electrocardiography (ECG)-determined LVH and to assess whether increased baPWV and ECG-determined LVH are independently associated with LVDD.MethodsThis cross-sectional study enrolled 270 patients and classified them into four groups according to the median value of baPWV and with/without ECG-determined LVH. The baPWV was measured using an ABI-form device. ECG-determined LVH was defined by Sokolow-Lyon criterion. LVDD was defined as impaired relaxation, pseudonormal, and restrictive mitral inflow patterns. Groups 1, 2, 3, and 4 were patients with lower baPWV and without ECG-determined LVH, lower baPWV but with ECG-determined LVH, higher baPWV but without ECG-determined LVH, and higher baPWV and with ECG-determined LVH respectively.ResultsEarly diastolic mitral velocity (Ea) was gradually decreased from group 1 to group 4 (p≦0.027). Patients in group 4 had the highest prevalence of LVDD (all p<0.001). After multivariate analysis, both baPWV and ECG-determined LVH were independent determinants of Ea (β = −0.02, P<0.001; β = −1.77, P<0.001 respectively) and LVDD (odds ratio = 1.02, P = 0.011 and odds ratio = 3.53, P = 0.013 respectively).ConclusionOur study showed the group with higher baPWV and ECG-determined LVH had the lowest Ea and highest prevalence of LVDD. In addition, both baPWV and ECG-determined LVH were independently associated with Ea and LVDD. Hence, assessment of arterial stiffness by baPWV and LVH by ECG may be useful in identifying the high risk group of LVDD.

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Section: Introductionmentioning

confidence: 61%

Association of Arterial Stiffness and Electrocardiography-Determined Left Ventricular Hypertrophy with Left Ventricular Diastolic Dysfunction

et al. 2012

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“…12 In the current study, we further validated that this classification was useful in stratifying the risk of renal function progression in CKD patients. High baPWV and bPEP/bET was independently associated with rapid renal progression and increased renal endpoints, which suggests that there might be an interaction between the heart, vessel and kidney.…”

Section: Discussionmentioning

confidence: 90%

“…Therefore, dividing patients into four groups using baPWV and bPEP/bET is useful in staging cardiovascular dysfunction. 12 However, no study has evaluated the association between cardiovascular dysfunction and renal dysfunction progression in CKD patients. The aim of this study was to assess whether the combination of baPWV and bPEP/bET is useful in identifying stage 3-5 CKD patients at risk for adverse renal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Brachial-ankle pulse wave velocity and brachial pre-ejection period to ejection time ratio with renal outcomes in chronic kidney disease

et al. 2012

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Heart failure and increased arterial stiffness are associated with declining renal function. This longitudinal study was designed to assess whether the combination of brachial-ankle pulse wave velocity (baPWV) and the ratio of brachial pre-ejection period (bPEP) to brachial ejection time (bET) was independently associated with renal outcomes in patients with chronic kidney disease (CKD), stages 3-5. The baPWV and bPEP/bET values were measured using an ankle-brachial index (ABI)-form device in 186 patients who were classified into 4 groups according to the baPWV and bPEP/bET median values. Renal function change was determined by estimated glomerular filtration rate (eGFR) slope. Rapid renal progression was defined as an eGFR slope less than À3 ml min À1 per 1.73 m 2 per year. The renal endpoints were defined as commencement of dialysis or X25% decline in eGFR. Among the four study groups, the group with high baPWV and bPEP/bET values had the lowest eGFR slope (Pp0.042). Multivariate analysis revealed that this group was independently associated with rapid renal progression (odds ratio, 9.560; P ¼ 0.009) and progression to renal endpoints (hazard ratio, 2.587; P ¼ 0.039). Our findings show that a combination of high baPWV and bPEP/bET is associated with adverse renal outcomes in patients with advanced CKD. Screening CKD patients by baPWV and bPEP/bET during the same examination may help identify patients with an elevated risk for adverse renal outcomes.

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“…For example, in some cases, dysfunction of vessels progresses first, and in other cases, dysfunction of the heart progresses first. In either case, patients can finally develop CV dysfunction as a result [18]. However, there is scarce literature discussing the impact of simultaneous consideration of cardiac and vascular function on the long-term all-cause and CV mortality.…”

Section: Introductionmentioning

confidence: 99%

Impact of Simultaneous Consideration of Cardiac and Vascular Function on Long-Term All-Cause and Cardiovascular Mortality

Hsu

Lee

Tsai

et al. 2019

JCM

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Background: Left ventricular ejection fraction (LVEF) is a good indicator of cardiac function, and brachial-ankle pulse wave velocity (baPWV) is a good indicator of vascular function. Both of them can predict cardiovascular (CV) outcomes. Objectives: There is scarce literature discussing the impact of simultaneous consideration of cardiac and vascular function on overall and CV mortality. Methods: We included 958 patients and classified them into four groups. Groups 1 to 4 were patients with LVEF ≥ 50% and baPWV below the median, LVEF < 50% but baPWV below the median, LVEF ≥ 50% but baPWV above the median, and LVEF < 50% and baPWV above the median, respectively. Results: The median follow-up to mortality was 93 (25th–75th percentile: 69–101) months. There were 91 cases of CV mortality and 238 cases of all-cause mortality. After multivariable analysis, age, gender, diabetes, mean blood pressure, group 2 versus group 1, and group 4 versus group 1 were significant predictors of all-cause mortality (P ≤ 0.038) and age, diabetes, mean blood pressure, group 2 versus group 1, and group 4 versus group 1 were significant predictors of CV mortality (P ≤ 0.008). Conclusions: Patients with higher LVEF and lower baPWV had a similar overall and CV mortality as patients with higher LVEF and baPWV. Patients with lower LVEF and higher baPWV had the highest overall and CV mortality among the four study groups. In addition, patients with lower LVEF alone had a higher CV mortality than the patients with higher baPWV alone. Therefore, simultaneous consideration of cardiac and vascular function may be useful in predicting overall and CV mortality.

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Impact of a systolic parameter, defined as the ratio of right brachial pre-ejection period to ejection time, on the relationship between brachial-ankle pulse wave velocity and left ventricular diastolic function

Cited by 12 publications

References 33 publications

Association of Arterial Stiffness and Electrocardiography-Determined Left Ventricular Hypertrophy with Left Ventricular Diastolic Dysfunction

Association of Arterial Stiffness and Electrocardiography-Determined Left Ventricular Hypertrophy with Left Ventricular Diastolic Dysfunction

Brachial-ankle pulse wave velocity and brachial pre-ejection period to ejection time ratio with renal outcomes in chronic kidney disease

Impact of Simultaneous Consideration of Cardiac and Vascular Function on Long-Term All-Cause and Cardiovascular Mortality

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