Int J Med Sci 2013; 10(11):1437-1444. doi:10.7150/ijms.5753
Association of Increased Arterial Stiffness and P Wave Dispersion with Left Ventricular Diastolic Dysfunction
1. Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;
2. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;
3. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
4. Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
Tsai WC, Lee KT, Kuo HF, Tang WH, Jhuo SJ, Chu CS, Lin TH, Hsu PC, Lin MY, Lin FH, Su HM, Voon WC, Lai WT, Sheu SH. Association of Increased Arterial Stiffness and P Wave Dispersion with Left Ventricular Diastolic Dysfunction. Int J Med Sci 2013; 10(11):1437-1444. doi:10.7150/ijms.5753. Available from http://www.medsci.org/v10p1437.htm
Background: 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.
Methods: 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.
Results: 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).
Conclusions: 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.
Keywords: brachial-ankle pulse wave velocity, P wave dispersion, left ventricular diastolic dysfunction.