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Minerva Cardioangiologica 2020 Feb 25

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 1 , Mohammed AMMAR 2, Magdy ISMAIL 2, Ahmed ELSHAZLY 1

1 Department of Cardiology, Ain Shams University, Cairo, Egypt; 2 Department of Cardiology, Helwan University, Helwan, 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), so 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: 100 patients with age > 50; were divided into two groups, case: 80 patients with asymptomatic LVDD with EF ≥50% and control: 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 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). Moreover, positive correlation with plasma BNP (r=0.958, P<0.001). 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: Aortic pulse wave velocity; Diastolic dysfunction; BNP; New diagnostic parameter for LVDD

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