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) > or = 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/Ea < or = 15) and the baPWV of the E/Ea >15 group was significantly increased compared to the E/Ea < or = 15 group (1,664.3 +/- 270.5 vs. 1,381.9 +/- 159.1 cm/s, P < 0.01). The baPWV showed better correlation with E/Ea (r = 0.69, P < 0.01) than the BNP (r = 0.47, 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/Ea >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.