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Aortic stiffness for the detection of preclinical left ventricular diastolic dysfunction: pulse wave velocity versus pulse pressure.
J Hypertens 2008; 26(4):758-64JH

Abstract

OBJECTIVE

An age-dependent relationship between aortic and left ventricular (LV) stiffening has been observed in community-based adults. Our aim was to compare the performances of wave reflection-dependent (pulse pressure) and independent [carotid-femoral pulse wave velocity (PWV)] indexes of aortic stiffness to detect preclinical LV diastolic dysfunction.

METHODS

In this case-control study, a stratified subsample of participants of a population-based echocardiographic survey with LV ejection fraction higher than 45% and without overt heart failure was randomly selected to undergo assessment of brachial blood pressure, LV diastolic function by Doppler echocardiography, and estimation of central aortic pressures and PWV by applanation tonometry.

RESULTS

Of the 233 subjects (mean age 73 +/- 6 years, 54% men), 84 had normal diastolic function, 99 had mild diastolic dysfunction, and 50 had moderate or severe diastolic dysfunction. Brachial pulse pressure, central pulse pressure, and PWV progressively increased according to the severity of diastolic dysfunction, independent of age and sex. The overall performance of PWV was superior to brachial pulse pressure [area under receiver operating characteristic curve (AUC): 0.70 versus 0.59, respectively; P = 0.005] and central pulse pressure (AUC: 0.70 versus 0.56, respectively; P = 0.001) for the detection of any diastolic dysfunction.

CONCLUSION

PWV appeared to be superior to central and brachial pulse pressure for the detection of diastolic dysfunction in older adults with 'preserved' LV ejection fraction.

Authors+Show Affiliations

Academic Unit of Internal Medicine, The Canberra Hospital, Canberra, Australia. walter.abhayaratna@act.gov.auNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18327086

Citation

Abhayaratna, Walter P., et al. "Aortic Stiffness for the Detection of Preclinical Left Ventricular Diastolic Dysfunction: Pulse Wave Velocity Versus Pulse Pressure." Journal of Hypertension, vol. 26, no. 4, 2008, pp. 758-64.
Abhayaratna WP, Srikusalanukul W, Budge MM. Aortic stiffness for the detection of preclinical left ventricular diastolic dysfunction: pulse wave velocity versus pulse pressure. J Hypertens. 2008;26(4):758-64.
Abhayaratna, W. P., Srikusalanukul, W., & Budge, M. M. (2008). Aortic stiffness for the detection of preclinical left ventricular diastolic dysfunction: pulse wave velocity versus pulse pressure. Journal of Hypertension, 26(4), pp. 758-64. doi:10.1097/HJH.0b013e3282f55038.
Abhayaratna WP, Srikusalanukul W, Budge MM. Aortic Stiffness for the Detection of Preclinical Left Ventricular Diastolic Dysfunction: Pulse Wave Velocity Versus Pulse Pressure. J Hypertens. 2008;26(4):758-64. PubMed PMID: 18327086.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aortic stiffness for the detection of preclinical left ventricular diastolic dysfunction: pulse wave velocity versus pulse pressure. AU - Abhayaratna,Walter P, AU - Srikusalanukul,Wichat, AU - Budge,Marc M, PY - 2008/3/11/pubmed PY - 2008/7/9/medline PY - 2008/3/11/entrez SP - 758 EP - 64 JF - Journal of hypertension JO - J. Hypertens. VL - 26 IS - 4 N2 - OBJECTIVE: An age-dependent relationship between aortic and left ventricular (LV) stiffening has been observed in community-based adults. Our aim was to compare the performances of wave reflection-dependent (pulse pressure) and independent [carotid-femoral pulse wave velocity (PWV)] indexes of aortic stiffness to detect preclinical LV diastolic dysfunction. METHODS: In this case-control study, a stratified subsample of participants of a population-based echocardiographic survey with LV ejection fraction higher than 45% and without overt heart failure was randomly selected to undergo assessment of brachial blood pressure, LV diastolic function by Doppler echocardiography, and estimation of central aortic pressures and PWV by applanation tonometry. RESULTS: Of the 233 subjects (mean age 73 +/- 6 years, 54% men), 84 had normal diastolic function, 99 had mild diastolic dysfunction, and 50 had moderate or severe diastolic dysfunction. Brachial pulse pressure, central pulse pressure, and PWV progressively increased according to the severity of diastolic dysfunction, independent of age and sex. The overall performance of PWV was superior to brachial pulse pressure [area under receiver operating characteristic curve (AUC): 0.70 versus 0.59, respectively; P = 0.005] and central pulse pressure (AUC: 0.70 versus 0.56, respectively; P = 0.001) for the detection of any diastolic dysfunction. CONCLUSION: PWV appeared to be superior to central and brachial pulse pressure for the detection of diastolic dysfunction in older adults with 'preserved' LV ejection fraction. SN - 0263-6352 UR - https://www.unboundmedicine.com/medline/citation/18327086/Aortic_stiffness_for_the_detection_of_preclinical_left_ventricular_diastolic_dysfunction:_pulse_wave_velocity_versus_pulse_pressure_ L2 - http://Insights.ovid.com/pubmed?pmid=18327086 DB - PRIME DP - Unbound Medicine ER -