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Minerva Cardioangiologica 2020 August;68(4):313-8

DOI: 10.23736/S0026-4725.20.05101-4


lingua: Inglese

Echocardiographic assessment of aortic pulse wave velocity as a diagnostic and prognostic parameter for left ventricular diastolic dysfunction

Haitham GALAL , Mohammed AMMAR, Magdy ISMAIL, Ahmed ELSHAZLY

Department of Cardiology, Ain Shams University, Cairo, Egypt

BACKGROUND: 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).
METHODS: 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.
RESULTS: 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%.
CONCLUSIONS: 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.

KEY WORDS: Natriuretic peptide, brain; Ventricular dysfunction, left; Pulse wave analysis

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