Relationship between Brachial-Ankle Pulse Wave Velocity and Left Ventricular Filling Pressure in Hypertensive Coronary Artery Disease Patients

Abstract

Background and Objectives: Pulse wave velocity (PWV) has been used as an index of arterial stiffness. The ratio of transmitral Doppler early filling velocity to tissue Doppler early diastolic mitral annular velocity (E/E') has been shown to be the most accurate noninvasive predictor of elevated left ventricular filling pressure (LVFP) or left ventricular diastolic function. However the relationship between PWV and LVFP in patients with coronary artery disease has not been thoroughly evaluated.Subjects and Methods: We studied 112 subjects with hypertension and coronary artery disease (mean age of 66 ± 8 years, 61.6% men) referred for brachialankle PWV (baPWV) determination who had had the E/E' determined using echocardiography within seven days. Results: The mean baPWV was 1,841 ± 410 cm/s and the mean E/E' was 14.8 ± 5.9. The E/E' was correlated with baPWV (r = 0.23, p = 0.016). Of the 112 subjects, 10 had a low E/E' (< 9), 56 had a moderate E/E' (9 to 15) and 46 had a high E/E' (> 15). No significant differences were found with respect to the mean age, sex, body mass index, cholesterol, diabetes mellitus, or smoking status in the three E/E' groups. The mean baPWV increased in a stepwise manner from the low, to moderate, to high E/E' groups (1,708 ± 271 cm/s, 1,756 ± 378 cm/s, and 1,974 ± 440 cm/s, respectively; p = 0.014). Conclusion: A progressively greater E/E' is associated with a greater baPWV. Arterial stiffness indicated by baPWV might be a predictor of LVFP or diastolic function in hypertensive coronary artery disease patient.