Association of increased arterial stiffness and p wave dispersion with left ventricular diastolic dysfunction.

The association between increased arterial stiffness and left ventricular diastolic dysfunction (LVDD) may be influenced by left ventricular performance. P wave dispersion is not only a significant determinant of left ventricular performance, but is also correlated with LVDD. This study is designed to compare left ventricular diastolic function among patients divided by brachial-ankle pulse wave velocity (baPWV) and corrected P wave dispersion (PWDC) and assess whether the combination of baPWV and PWDC can predict LVDD more accurately. This cross-sectional study enrolled 270 patients and classified them into four groups according to the median values of baPWV and PWDC. LVDD was defined as impaired relaxation and pseudonormal/restrictive mitral inflow patterns. The ratio of transmitral E wave velocity to early diastolic mitral annulus velocity (E/Ea) was higher in group with higher baPWV and PWDC than in the other groups (all p <0.001). The prevalence of LVDD was higher in group with higher baPWV and PWDC than in the two groups with lower baPWV (p ≤ 0.001). The baPWV and PWDC were correlated with E/Ea and LVDD in multivariate analysis (p ≤ 0.030). The addition of baPWV and PWDC to a clinical mode could significantly improve the R square in prediction of E/Ea and C statistic and integrated discrimination index in prediction of LVDD (p ≤ 0.010). This study showed increased baPWV and PWDC were correlated with high E/Ea and LVDD. The addition of baPWV and PWDC to a clinical model improved the prediction of high E/Ea and LVDD. Screening patients by means of baPWV and PWDC might help identify the high risk group of elevated left ventricular filling pressure and LVDD.

Citation

Wei-Chung Tsai, Kun-Tai Lee, Hsuan-Fu Kuo, Wei-Hua Tang, Shih-Jie Jhuo, Chih-Sheng Chu, Tsung-Hsien Lin, Po-Chao Hsu, Ming-Yen Lin, Feng-Hsien Lin, Ho-Ming Su, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu. Association of increased arterial stiffness and p wave dispersion with left ventricular diastolic dysfunction. International journal of medical sciences. 2013;10(11):1437-44

Mesh Tags

PMID: 24046515

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