Division of Cardiology (H-MS, T-HL, P-CH, C-SL, W-HL, W-CV, W-TL, S-HS), Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital (S-CC), Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine (H-MS, S-CC), Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; and Faculty of Medicine (H-MS, T-HL0, C-SL, S-CC, W-CV, W-TL, S-HS), College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Am J Med Sci. 2014 Apr;347(4):289-94. doi: 10.1097/MAJ.0b013e31828c5bee.
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.
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.
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.
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.
动脉僵硬度、外周动脉疾病和左心室收缩功能障碍导致左心室肥厚（LVH）。使用 ABI 形式的设备，我们可以获得肱踝脉搏波速度（baPWV）、踝臂指数（ABI）和射血前期与射血时间的比值（bPEP/bET），它们分别是动脉僵硬度、外周动脉疾病和左心室收缩功能的标志物。本研究旨在评估 3 项 baPWV、ABI 和 bPEP/bET 测量值计算得出的“BAP 评分”是否与 LVH 相关。
共有 1146 名患者纳入本研究。BAP 评分根据以下评分系统计算，即 1 分赋值给 baPWV 值高于中位数 1670cm/s、ABI 在任一脚小于 0.9 或大于等于 1.3 和 bPEP/bET 大于 0.38。
随着 BAP 评分从 0 分到 3 分的逐步增加，左心房直径、左心室质量指数（LVMI）和 LVH 的患病率呈显著增加趋势，左心室射血分数呈逐步降低趋势。此外，增加的 BAP 评分与 LVMI 和 LVH 的增加显著相关。
我们的结果表明，增加的 BAP 评分与 LVMI 和 LVH 相关，独立于传统危险因素，如年龄、糖尿病、高血压、肥胖、贫血、高脂血症和慢性肾脏病。因此，从同一检查中获得的 BAP 评分可能有助于识别 LVMI 和 LVH 增加的患者。
