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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism
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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism

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Association of increased arterial stiffness and p wave dispersion with left ventricular diastolic dysfunction

Wei-Chung Tsai1, Kun-Tai Lee, Hsuan-Fu Kuo

  • 11. Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 2. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;

International Journal of Medical Sciences
|September 19, 2013
PubMed

Insights

Increased arterial stiffness and P wave dispersion are linked to left ventricular diastolic dysfunction. Combining these measures, brachial-ankle pulse wave velocity (baPWV) and corrected P wave dispersion (PWDC), improves prediction of this condition.

Area of Science:

  • Cardiology
  • Vascular Physiology
  • Echocardiography

Background:

  • Arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV), is associated with left ventricular diastolic dysfunction (LVDD).
  • P wave dispersion (PWd), a marker of left ventricular performance, also correlates with LVDD.
  • The interplay between arterial stiffness and P wave dispersion in predicting LVDD requires further investigation.

Purpose of the Study:

  • To compare left ventricular diastolic function in patients stratified by baPWV and corrected P wave dispersion (PWDC).
  • To evaluate the combined predictive accuracy of baPWV and PWDC for LVDD.

Main Methods:

  • A cross-sectional study involving 270 patients.
  • Patients were categorized into four groups based on median baPWV and PWDC values.
  • LVDD was diagnosed using mitral inflow patterns; diastolic function assessed via E/Ea ratio.

Main Results:

  • Higher baPWV and PWDC were significantly associated with increased E/Ea and a higher prevalence of LVDD (p < 0.001).
  • Both baPWV and PWDC independently predicted E/Ea and LVDD in multivariate analysis (p ≤ 0.030).
  • The combination of baPWV and PWDC significantly enhanced the prediction of E/Ea and LVDD in a clinical model.

Conclusions:

  • Elevated baPWV and PWDC correlate with impaired left ventricular diastolic function and LVDD.
  • Combining baPWV and PWDC improves the prediction of high E/Ea and LVDD.
  • Screening with baPWV and PWDC may identify patients at high risk for elevated left ventricular filling pressure and LVDD.
Abstract

Keywords:
P wave dispersionbrachial-ankle pulse wave velocityleft ventricular diastolic dysfunction.

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