Noninvasive Brachial-Ankle Pulse Wave Velocity in Hypertensive Patients With Left Ventricular Hypertrophy

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 1,3819 +/- 159.1 cm/s, P < 0.01). The baPWV showed better correlation with E/E(a) (r=0 69, P < 0 01) than the BNP (r=047, 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 1,440 cm/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.