Noninvasive brachial-ankle pulse wave velocity in hypertensive patients with left ventricular hypertrophy

Abstract

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. 1,381.9 159.1cm/s, P 0.01). The baPWV showed better correlation with E/E a (r = 0.69, P 0.01) than the BNP (r = 0.47, 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 1,440cm/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. © 2010 American Journal of Hypertension, Ltd.