Department of Cardiology, Ain Shams University, Cairo, Egypt -
Department of Cardiology, Ain Shams University, Cairo, Egypt.
Minerva Cardioangiol. 2020 Aug;68(4):313-318. doi: 10.23736/S0026-4725.20.05101-4. Epub 2020 Feb 25.
Aortic pulse wave velocity (PWV) is a standard measurement of aortic stiffness. It has been suggested that increased arterial stiffness promotes left ventricular diastolic dysfunction (LVDD). We designed this study to evaluate role of aortic PWV as a new diagnostic parameter for LVDD by correlation with echocardiographic LVDD indices and to evaluate its prognostic value in patients with LVDD by correlation with brain natriuretic peptide (BNP).
One hundred patients with age >50 were divided into two groups: case group consisted of 80 patients with asymptomatic LVDD with EF ≥50% while controlgroup consisted of 20 patients with normal LVDD. BNP blood test and echocardiography with assessment of aortic PWV were done.
Mean age was 59±7.47 vs. 57±6.35 years in case and control groups respectively (P= 0.73), 38 (47.5%) males in case vs. 9 (45%) in control (P=0.84). Aortic PWV showed positive correlation with E/e' (r=0.957, P<0.001), tricuspid regurgitation (TR) velocity (r=0.941, P<0.001), and LA volume index (r=0.947, P<0.001). Negative correlation with septal e' (r=-0.970, P<0.001) and lateral e' (r=-0.932, P<0.001) were reported. Moreover, positive correlation with plasma BNP (r=0.958, P<0.001) was reported. The area under the ROC curve for aortic PWV to detect DD was 0.86 (95% CI, 0.76-0.98; P<0.001) and the optimal cutoff point of 12.5 m/s produced 92.3% sensitivity and 75.0% specificity with an accuracy of 89.0%.
Echocardiographic assessment of aortic PWV appears not only to be a sensitive and reliable for LVDD detection but also has a promising prognostic value in patients with LVDD.
主动脉脉搏波速度（PWV）是主动脉僵硬度的标准测量指标。有研究表明，动脉僵硬度的增加会促进左心室舒张功能障碍（LVDD）。我们设计了这项研究，通过与超声心动图 LVDD 指标相关来评估主动脉 PWV 作为 LVDD 的新诊断参数的作用，并通过与脑钠肽（BNP）相关来评估其在 LVDD 患者中的预后价值。
将 100 名年龄>50 岁的患者分为两组：病例组由 80 名无症状性 LVDD 伴 EF≥50%的患者组成，对照组由 20 名正常 LVDD 的患者组成。进行 BNP 血液检查和超声心动图检查，评估主动脉 PWV。
病例组的平均年龄为 59±7.47 岁，对照组为 57±6.35 岁（P=0.73）；病例组中 38 名（47.5%）男性，对照组中 9 名（45%）男性（P=0.84）。主动脉 PWV 与 E/e'（r=0.957，P<0.001）、三尖瓣反流速度（r=0.941，P<0.001）和左心房容积指数（r=0.947，P<0.001）呈正相关。与间隔侧 e'（r=-0.970，P<0.001）和外侧 e'（r=-0.932，P<0.001）呈负相关。此外，还报告了与血浆 BNP 之间的正相关关系（r=0.958，P<0.001）。主动脉 PWV 检测 DD 的 ROC 曲线下面积为 0.86（95%CI，0.76-0.98；P<0.001），最佳截断点为 12.5 m/s，灵敏度为 92.3%，特异性为 75.0%，准确性为 89.0%。
超声心动图评估主动脉 PWV 不仅对 LVDD 的检测具有敏感性和可靠性，而且对 LVDD 患者具有有前景的预后价值。
