Associations of pulse pressure index with left ventricular filling pressure and diastolic dysfunction in patients with chronic kidney disease

Abstract

Background:Patients with chronic kidney disease (CKD) often have poor vascular compliance and poor left ventricular diastolic dysfunction (LVDD). The pulse pressure index (PPI) defined as ((systolic blood pressure-diastolic blood pressure)/systolic blood pressure) reflects vascular compliance. Vascular compliance is reportedly associated with left ventricular diastolic function. This study of CKD patients investigated whether PPI correlates with the ratio of transmitral E wave velocity (E) to early diastole mitral annulus velocity (Ea) or with LVDD.Methods:This study enrolled 511 CKD patients who had been referred for echocardiographic examination. Blood pressure was automatically measured with an ABI-form device. The LVDD was defined as E-to-transmitral A wave velocity ratio of ≥0.9, Ea <8cm/s, or E/Ea ≥15.Results:Compared with those with E/Ea <15, patients with E/Ea ≥15 had significantly higher systolic blood pressure, pulse pressure, and PPI (all P < 0.001). Multivariable analysis showed that PPI was independently associated with E/Ea (unstandardized coefficient β = 1.348; P < 0.001) and with LVDD (odds ratio = 1.441 per 0.064 increase; P < 0.001).Conclusions:This study showed that increased PPI significantly correlates with elevated E/Ea and LVDD in CKD patients. Because PPI can be rapidly acquired during blood pressure measurement, it may be helpful for identifying CKD patients with a high left ventricular filling pressure and LVDD. © 2013 American Journal of Hypertension, Ltd.