scholarly journals Brachial-Ankle Pulse Wave Velocity Is the Only Index of Arterial Stiffness That Correlates with a Mitral Valve Indices of Diastolic Dysfunction, but No Index Correlates with Left Atrial Size

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Bryan Chow ◽  
Simon W. Rabkin

The objective of this study was to determine the optimal assessment of arterial stiffness that relates to diastolic dysfunction. Forty-one patients had measurements of brachial-ankle pulse wave velocity (baPWV), carotid-femoral pulse wave velocity (cfPWV), ankle brachial index (ABI), pulse pressure (PP), and augmentation index (AIx). Diastolic dysfunction was evaluated by echocardiographic indices of the ratio of the peak early diastolic mitral valve velocity and the peak late diastolic velocity (E/Aratio), left atrial diameter, and left atrial volume indexes. There was a significant (P<0.05) correlation between baPWV andE/Aratio with an inverse relationship indicating that higher arterial stiffness was associated with greater diastolic dysfunction. In contrast, there was no significant correlation betweenE/Aratio and cfPWV, PP, ABI, or AIx. After multivariate analysis, the relationship between baPWV andE/Aratio remained significant (P<0.05), independent of age and systolic blood pressure (BP). There were no correlations between any index of vascular stiffness and left atrial dimension or volume. In summary, baPWV correlates with diastolic dysfunction, independent of a patient’s age and BP and is a better indicator of diastolic dysfunction than other indicators of arterial stiffness. baPWV has the utility of infering the presence of left ventricular diastolic dysfunction.

2011 ◽  
Vol 18 (6) ◽  
pp. 790-796 ◽  
Author(s):  
Peter Wohlfahrt ◽  
Daniel Palouš ◽  
Michaela Ingrischová ◽  
Alena Krajčoviechová ◽  
Jitka Seidlerová ◽  
...  

Background: Ankle brachial index (ABI) has been increasingly used in general practice to identify individuals with low ABI at high cardiovascular risk. However, there has been no consensus on the clinical significance of high ABI. The aim of our study was to compare aortic stiffness as a marker of cardiovascular risk in individuals with low (<1.0), normal (1.0–1.4), and high ABI (>1.4). Methods: A total of 911 individuals from the Czech post-MONICA study (a randomly selected 1% representative population sample, aged 54 ± 13.5 years, 47% of men) were examined. ABI was measured using a handheld Doppler and aortic pulse wave velocity (aPWV) using the Sphygmocor device. Results: Of the 911 individuals, 28 (3.1%) had low ABI and 23 (2.5%) high ABI. There was a U-shaped association between aPWV and ABI. aPWV was significantly higher in individuals with low and high ABI compared with the normal ABI group (11.1 ± 2.8, 8.3 ± 2.3, p < 0.001; 10.8 ± 2.5, 8.3 ± 2.3 m/s, p < 0.001, respectively). In a model adjusted for age, sex, systolic, diastolic, mean blood pressure and examiner, aPWV remained increased in both extreme ABI groups compared with the normal ABI group. In logistic regression analysis, aPWV together with glucose level, male sex, and a history of deep venous thrombosis were independent predictors of high ABI, while cholesterol was not. Conclusion: This is the first study showing increased aortic stiffness in individuals with high ABI, presumably responsible for increased left ventricular mass described previously in this group. These findings suggest increased cardiovascular risk of high ABI individuals.


Angiology ◽  
2008 ◽  
Vol 60 (1) ◽  
pp. 82-86 ◽  
Author(s):  
Oladipupo Olafiranye ◽  
Ghazanfar Qureshi ◽  
Louis Salciccioli ◽  
Kinda Vernon-Jones ◽  
Charles Philip ◽  
...  

Background increased arterial stiffness is a predictor of cardiovascular events. The stroke volume (SV) to pulse pressure (PP) ratio is an estimate of arterial capacitance. Pulse wave velocity (PWV) is a measure of arterial stiffness. This study evaluated the effect of left ventricular (LV) SV on the SV/PP–PWV relationship. Methods 97 patients had applanation tonometry and echocardiography to measure arterial capacitance (SV/PP), PWV, and central aortic pressure. Results 50 patients had normal SV and 47 had low SV. For all patients, PWV inversely correlated with SV/PP. PWV and SV/PP correlated more strongly in the normal SV group than in the low SV group. Aortic PP was significantly correlated with PWV in all patients, in the normal SV group, and in the low SV group. Conclusion effective arterial capacitance correlates with PWV. The presence of decreased SV weakens the relationship.


Author(s):  
Ramachandran S. Vasan ◽  
Rebecca J. Song ◽  
Vanessa Xanthakis ◽  
Alexa Beiser ◽  
Charles DeCarli ◽  
...  

We characterized the prevalence, correlates, and prognosis of hypertension-mediated organ damage (HMOD) in the community-based Framingham Study. 7898 participants (mean age 51.6 years, 54% women) underwent assessment for the following HMOD: electrocardiographic and echocardiographic left ventricular hypertrophy, abnormal brain imaging findings consistent with vascular injury, increased carotid intima-media thickness, elevated carotid-femoral pulse wave velocity, reduced kidney function, microalbuminuria, and low ankle-brachial index. We characterized HMOD prevalence according to blood pressure (BP) categories defined by four international BP guidelines. Participants were followed up for incidence of cardiovascular disease. The prevalence of HMOD varied positively with systolic BP and pulse pressure but negatively with diastolic BP; it increased with age, was similar in both sexes, and varied across BP guidelines based on their thresholds defining hypertension. Among participants with hypertension, elevated carotid-femoral pulse wave velocity was the most prevalent HMOD (40%–60%), whereas low ankle-brachial index was the least prevalent (<5%). left ventricular hypertrophy, reduced kidney function, microalbuminuria, increased carotid intima-media thickness, and abnormal brain imaging findings had an intermediate prevalence (20%–40%). HMOD frequently clustered within individuals. On follow-up (median, 14.1 years), there were 384 cardiovascular disease events among 5865 participants with concurrent assessment of left ventricular mass, carotid-femoral pulse wave velocity, kidney function, and microalbuminuria. For every BP category above optimal (referent group), the presence of HMOD increased cardiovascular disease risk compared with its absence. The prevalence of HMOD varies across international BP guidelines based on their different thresholds for defining hypertension. The presence of HMOD confers incremental prognostic information regarding cardiovascular disease risk at every BP category.


2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Li-jie Qiao ◽  
Zhen Qi ◽  
Li-ping Tu ◽  
Yu-hang Zhang ◽  
Li-ping Zhu ◽  
...  

This study aims at exploring the cardiovascular pathophysiological mechanism of TCM (traditional Chinese medicine) pulse by detecting the correlation between radial artery pulse wave variables and pulse wave velocity/echocardiographic parameters. Two hundred Chinese subjects were enrolled in this study, which were grouped into health control group, hypertension group, and hypertensive heart disease group. Physical data obtained in this study contained TCM pulse images at “Guan” position of the left hand, pulse wave velocity, and echocardiographic parameters. Linear and stepwise regression analysis was performed to assess the association of radial artery pulse wave variables with pulse wave velocity and echocardiographic parameters in the total population and in each different group. After adjusting for related confounding factors, decrease of t1, t5 and increase of h1, h3/h1 were statistically associated with arterial stiffness in the total population (P<0.05). Moreover, the correlation study in each group showed that the decrease of both t3 and h5 was also related to arterial stiffness (P<0.05). In terms of echocardiographic parameters, the height of dicrotic wave indicated by h5 was the most relevant pulse wave variable. For the health control, h5 was negatively associated with interventricular septal thickness (VST) and left ventricular posterior wall thickness (PWT) (P<0.05), while for the hypertension population and those with target-organ damage to heart, increase of h5 might be associated with decrease of ejection fraction (EF) and increase of all the remaining echocardiographic parameters especially for left ventricular end-systolic diameter (LVDs) and Left ventricular end-diastolic diameter (LVDd) (P<0.05). In conclusion, we found radial artery pulse wave variables were in association with the arterial stiffness and echocardiographic changes in hypertension, which would provide an experimental basis for cardiovascular pathophysiological mechanism of radial artery pulse wave variables.


2020 ◽  
Vol 9 (12) ◽  
pp. 3924
Author(s):  
Marlena Paniczko ◽  
Małgorzata Chlabicz ◽  
Jacek Jamiołkowski ◽  
Paweł Sowa ◽  
Małgorzata Szpakowicz ◽  
...  

Background: Left ventricular diastolic dysfunction (LVDD) is caused by a decreased left ventricle relaxation and is associated with an increased risk of symptomatic heart failure (HF) and excessive mortality. Aim: To evaluate the frequency and factors related to LVDD in the population with chronic coronary syndromes (CCS). Methods: 200 patients (mean age 63.18 ± 8.12 years, 75.5% male) with CCS were included. LVDD was diagnosed based on the recent echocardiography guidelines. Results: LVDD was diagnosed in 38.5% of CCS population. From the studied factors, after adjustment for age, sex, and N-terminal pro-brain natriuretic peptide (NT-proBNP), LVDD associated positively with android/gynoid (A/G) fat mass ratio, left ventricular mass index (LVMI), and negatively with Z-score and left ventricular ejection fraction (LVEF). In stepwise backward logistic regression analysis, the strongest factors associated with LVDD were pulse wave velocity value, handgrip strength and waist to hip ratio (WHR). Conclusions: LVDD is common among CCS patients and it is associated with parameters reflecting android type fat distribution regardless of NT-proBNP and high-sensitivity troponin T concentrations. Deterioration in diastolic dysfunction is linked with increased aortic stiffness independently of age and sex. Further studies evaluating the effects of increasing physical fitness and lowering abdominal fat accumulations on LVDD in CCS patients should be considered.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N Georgieva ◽  
A Borizanova - Petkova ◽  
E Kinova ◽  
A Goudev

Abstract BACKGROUND Vascular stiffness and left atrial volume index (LAVI) are predictors of cardiovascular complications in hypertensive patients. The correlation of left atrium (LA) with left ventricle (LV) – arterial functional changes has not been well established. PURPOSE To investigate the relationship between LA remodeling and ventriculoarterial function. METHODS We studied 70 consecutive middle-aged patients (54 ± 13 years), separated in two groups: 55 with mild to moderate hypertension and duration up to 5 years and 15 healthy controls. All parameters for arterial stiffness – 24-hour central systolic pressure (cSys24h), central pulse pressure (cPP24h), augmentation index 24h (Aix24h) and 24-hour pulse wave velocity (PWV24h) were measured non–invasively with oscillometric method by Mobil-O-graph PWA. All patients underwent standard two-dimentional echocardiography with Spackle tracking analysis for LA and LV global longitudinal strain (GLS). RESULTS Statistically significant differences in parameters of vascular stiffness were found in patients with hypertension in comparison with healthy controls: cSys24h (116.64 ± 10.52 vs. 108.4 ± 6.19 mm Hg, p &lt; 0.001), cPP24h (47.64 ± 9.43 vs. 40.4 ± 4.98 mmHg, p &lt; 0.001), PWV24h (8.59 ± 1.49 vs. 6.29 ± 0.91 m/s, p &lt; 0.0001). Patients with hypertension have higher LV filling pressures: E/e ratio (9.62 ± 3.13 vs. 7.62 ± 1.58, p &lt; 0.006), higher velocities of A–wave transmitral blood flow (85.15 ± 16.88 vs. 64.57 ± 13.76 cm/s, p &lt; 0.0001), dilated LA (LAVI: 33.78 ± 10.68 vs. 24.96 ± 4.89 ml/m², p &lt; 0.001) and reduced LA GLS (29.34 ± 3.45 vs. 41.33 ± 4.37%, p &lt; 0.0001) in comparison to control group. There were no statistically significant differences in Aix24h and cardiac output between the two groups. There is moderate positive correlation between LAVI with cPP24h (r = 0.491, p &lt; 0.0001) and cSys24h (r = 0.366, p &lt; 0.004). We found moderate positive correlation between LAVI and LV mass index (r = 0.386, p &lt; 0.002). PWV24h correlated moderately and positively with LAVI (r = 0.404, p&lt; 0.0001), and negatively with LA GLS (r = -0.471, p &lt; 0.0001). CONCLUSION: LA remodeling is determined by the high 24-hour values of non-invasively measured central systolic pressure and pulse wave velocity. The parameters of arterial stiffness - cSys24h, cPP24h correlate positively with LA. PWV24h correlates negatively with reservoir strain of the left atrium. Using the method in clinical practice can improve risk stratification and therapeutic management. Further investigations are needed for prognostic and therapeutic value of LA remodeling.


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