Noninvasive Brachial-Ankle Pulse Wave Velocity in Hypertensive Patients With Left Ventricular Hypertrophy

作者：Park Kyoung Ha^*; Park Woo Jung; Kim Min Kyu; Jung Jae Hun; Choi Seonghoon; Cho Jung Rae; Kim Hyun Sook; Lee Namho; Cho Goo Yeong

来源：American Journal of Hypertension, 2010, 23(3): 269-274.

DOI：10.1038/ajh.2009.243

• blood pressure
• brachial-ankle pulse wave velocity
• hypertension
• left ventricular hypertrophy

BACKGROUND The elevation of left ventricular filling pressure (LVFP) could be an important prognostic factor in patients with hypertension. We hypothesized that noninvasive brachial-ankle pulse wave velocity (baPWV) is associated with increased LVFP in hypertensive patients with LV hypertrophy (LVH)
METHODS
We enrolled patients with well-controlled hypertension for more than 1 year with LV ejection fraction (LVEF) >= 55%, and LVH The relationship between Doppler echocardiographic parameters of LVFP and baPWV with B-type natriuretic peptide (BNP) was also evaluated
RESULTS
A total of 62 patients were enrolled (31 patients with E/E(a) > 15 and 31 patients with E/E(a) <= 15) and the baPWV of the E/E(a) > 15 group was significantly increased compared to the E/E(a) <= 15 group (1,664.3 +/- 270 5 vs 1,3819 +/- 159.1 cm/s, P < 0.01). The baPWV showed better correlation with E/E(a) (r=0 69, P < 0 01) than the BNP (r=047, P < 0.01). A multivariate linear regression model showed that only baPWV was significantly correlated with E/E(a), and that the association was independent of other factors The area under the receiver-operating characteristic (ROC) curve of baPWV for the detection of elevated LVFP (E/E(a) > 15) was 0.79 (P < 0 01) and the optimal cutoff point of 1,440 cm/s produced 75% sensitivity and 62% specificity (the positive and negative predictive values were 68 and 71%, respectively).
CONCLUSIONS
In this study, we have demonstrated that elevated baPWV is associated with noninvasive markers of increased LVFP in hypertensive LVH patients with preserved LV systolic function.

• 出版日期2010-3