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

Soongu Kwak1, Hack-Lyoung Kim1, Minjae In2

  • 1Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea.

Frontiers in Cardiovascular Medicine
|May 27, 2021
PubMed

Insights

Brachial-ankle pulse wave velocity (baPWV) effectively screens for left ventricular (LV) remodeling and diastolic dysfunction in untreated hypertensive patients. This simple test identifies early adverse cardiac changes, aiding timely intervention.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Physiology

Background:

  • Brachial-ankle pulse wave velocity (baPWV) is a convenient measure, but its utility in screening hypertensive patients for cardiac changes is unclear.
  • Left ventricular (LV) geometry and diastolic function are crucial indicators of cardiovascular risk in hypertension.

Purpose of the Study:

  • To investigate the association between baPWV and LV geometry and diastolic function in treatment-naive hypertensive patients.
  • To evaluate baPWV as a potential screening tool for early detection of adverse cardiac features in hypertension.

Main Methods:

  • Prospective enrollment of 202 untreated hypertensive patients without prior cardiovascular disease.
  • Simultaneous measurement of baPWV and transthoracic echocardiography before initiating antihypertensive treatment.
  • Statistical analysis including multiple linear regression and receiver operating characteristic (ROC) curve analysis.

Main Results:

  • Adjusted baPWV showed significant correlations with LV mass index (β=0.286, P=0.002), relative wall thickness (β=0.219, P=0.021), septal e' velocity (β=-0.199, P=0.018), E/e' ratio (β=0.373, P<0.001), left atrial volume index (β=0.334, P<0.001), and maximal tricuspid regurgitation velocity (β=0.401, P<0.001).
  • Elevated baPWV was observed in patients with LV hypertrophy (P=0.008), abnormal LV remodeling (P=0.035), and diastolic dysfunction (P<0.001).
  • ROC analysis indicated baPWV's discriminant ability for LV hypertrophy (AUC=0.646, P=0.004) and diastolic dysfunction (AUC=0.734, P<0.001).

Conclusions:

  • baPWV is significantly associated with left ventricular remodeling and diastolic dysfunction in untreated hypertensive individuals.
  • baPWV demonstrates potential as a valuable, non-invasive screening tool for identifying early adverse cardiac structural and functional changes in hypertensive patients.

Keywords:
arterial stiffnessdiastolic functionhypertensionleft ventricular remodelingpulse wave velocity

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