Association of brachial-ankle pulse wave velocity, ankle-brachial index and ratio of brachial pre-ejection period to ejection time with left ventricular hypertrophy.

BACKGROUND

Arterial stiffness, peripheral artery disease and left ventricular systolic dysfunction contributed to left ventricular hypertrophy (LVH). Using an ABI-form device, we can obtain brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and the ratio of brachial pre-ejection period to ejection time (bPEP/bET), which are markers for arterial stiffness, peripheral artery disease and left ventricular systolic function, respectively. The aim of this study was to assess whether "BAP score" calculated from the 3 measures of baPWV, ABI and bPEP/bET is associated with LVH.

METHODS

A total of 1,146 patients were included in the study. BAP score was calculated based on a point system in which 1 point was assigned for baPWV above the median value of 1670 cm/s, ABI < 0.9 or ≥ 1.3 in either leg and bPEP/bET > 0.38.

RESULTS

There was a significant trend for a stepwise increase in the left atrial diameter, left ventricular mass index (LVMI) and the prevalence of LVH and a stepwise decrease in the left ventricular ejection fraction corresponding to advancement in BAP score from 0 to 3. In addition, increased BAP score is significantly associated with increased LVMI and LVH.

CONCLUSIONS

Our results demonstrated increased BAP score was related to increased LVMI and LVH independent of traditional risk factors such as old age, diabetes, hypertension, obesity, anemia, hyperlipidemia and chronic kidney disease. Therefore, the BAP score obtained from the same examination might be useful and convenient in identifying patients with increased LVMI and LVH.