Association of Increased Arterial Stiffness and P Wave Dispersion with Left Ventricular Diastolic Dysfunction

作者：Tsai Wei Chung; Lee Kun Tai; Kuo Hsuan Fu; Tang Wei Hua; Jhuo Shih Jie; Chu Chih Sheng; Lin Tsung Hsien; Hsu Po Chao; Lin Ming Yen; Lin Feng Hsien; Su Ho Ming^*; Voon Wen Chol; Lai Wen Ter; Sheu Sheng Hsiung

来源：International Journal of Medical Sciences, 2013, 10(11): 1437-1444.

DOI：10.7150/ijms.5753

• brachial-ankle pulse wave velocity
• P wave dispersion
• left ventricular diastolic dysfunction

Background: The association between increased arterial stiffness and left ventricular diastolic dysLVDD) may be influenced by left ventricular performance. P wave dispersion is not only a significant determinant of left ventricular performance, but is also correlated with LVDD. This study is designed to compare left ventricular diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV) and corrected P wave dispersion (PWDC) and assess whether the combination of baPWV and PWDC can predict LVDD more accurately. %26lt;br%26gt;Methods: This cross-sectional study enrolled 270 patients and classified them into four groups according to the median values of baPWV and PWDC. LVDD was defined as impaired relaxation and pseudonormal/restrictive mitral inflow patterns. %26lt;br%26gt;Results: The ratio of transmitral E wave velocity to early diastolic mitral annulus velocity (E/Ea) was higher in group with higher baPWV and PWDC than in the other groups (all p %26lt; 0.001). The prevalence of LVDD was higher in group with higher baPWV and PWDC than in the two groups with lower baPWV (p %26lt;= 0.001). The baPWV and PWDC were correlated with E/Ea and LVDD in multivariate analysis (p %26lt;= 0.030). The addition of baPWV and PWDC to a clinical mode could significantly improve the R square in prediction of E/Ea and C statistic and integrated discrimination index in prediction of LVDD (p %26lt;= 0.010). %26lt;br%26gt;Conclusions: This study showed increased baPWV and PWDC were correlated with high E/Ea and LVDD. The addition of baPWV and PWDC to a clinical model improved the prediction of high E/Ea and LVDD. Screening patients by means of baPWV and PWDC might help identify the high risk group of elevated left ventricular filling pressure and LVDD.

• 出版日期2013