TY - JOUR
T1 - Enhanced radial late systolic pressure augmentation in hypertensive patients with left ventricular hypertrophy
AU - Hashimoto, Junichiro
AU - Watabe, Daisuke
AU - Hatanaka, Rieko
AU - Hanasawa, Tomohiro
AU - Metoki, Hirohito
AU - Asayama, Kei
AU - Ohkubo, Takayoshi
AU - Totsune, Kazuhito
AU - Imai, Yutaka
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2006/1
Y1 - 2006/1
N2 - Background: Wave reflection augments central blood pressure (BP) in late systole, thus increasing cardiac afterload. We examined the relationship between late systolic pressure augmentation in the peripheral radial artery pulse wave and the existence of left ventricular hypertrophy (LVH) in hypertension. Methods: Brachial BP, radial augmentation index (AIr), and carotid-femoral pulse wave velocity (PWVcf) were determined in 77 untreated hypertensive patients aged 56 ± 10 years. Cardiac structure and function were assessed by ultrasound, and LVH was defined based on the LV mass index (LVMI). Using multivariate analysis, patient characteristics were compared between those with (+) and without (-) LVH. Results: The LVMI was correlated independently and positively with AIr (β = 0.33, P = .004) and the brachial mean arterial pressure (MAP; β = 0.25, P = .03). The ratio of early to atrial peak velocities (E/A ratio) of the diastolic transmitral flow tended to be correlated negatively with the AIr. The LVH (+) group had a significantly higher AIr than the LVH (-) group [LVH (+), 97% v LVH (-), 89%, P = .003]; this difference remained significant even after adjustment for age, gender, MAP, and heart rate. The adjusted relative risk of LVH was 1.99 for each 10% AIr increase (P = .005). In contrast, LVMI was not correlated with the PWVcf, and the PWVcf was not different between the LVH (+) and LVH (-) groups. Moreover, there was no significant correlation between PWVcf and AIr. Conclusions: These results suggest that the peripheral AIr measurement is clinically useful in predicting LVH. Enhanced wave reflection may be related to the development of LVH in hypertensive patients.
AB - Background: Wave reflection augments central blood pressure (BP) in late systole, thus increasing cardiac afterload. We examined the relationship between late systolic pressure augmentation in the peripheral radial artery pulse wave and the existence of left ventricular hypertrophy (LVH) in hypertension. Methods: Brachial BP, radial augmentation index (AIr), and carotid-femoral pulse wave velocity (PWVcf) were determined in 77 untreated hypertensive patients aged 56 ± 10 years. Cardiac structure and function were assessed by ultrasound, and LVH was defined based on the LV mass index (LVMI). Using multivariate analysis, patient characteristics were compared between those with (+) and without (-) LVH. Results: The LVMI was correlated independently and positively with AIr (β = 0.33, P = .004) and the brachial mean arterial pressure (MAP; β = 0.25, P = .03). The ratio of early to atrial peak velocities (E/A ratio) of the diastolic transmitral flow tended to be correlated negatively with the AIr. The LVH (+) group had a significantly higher AIr than the LVH (-) group [LVH (+), 97% v LVH (-), 89%, P = .003]; this difference remained significant even after adjustment for age, gender, MAP, and heart rate. The adjusted relative risk of LVH was 1.99 for each 10% AIr increase (P = .005). In contrast, LVMI was not correlated with the PWVcf, and the PWVcf was not different between the LVH (+) and LVH (-) groups. Moreover, there was no significant correlation between PWVcf and AIr. Conclusions: These results suggest that the peripheral AIr measurement is clinically useful in predicting LVH. Enhanced wave reflection may be related to the development of LVH in hypertensive patients.
KW - Augmentation index
KW - Hypertension
KW - Left ventricular hypertrophy
KW - Radial pulse wave
KW - Wave reflection
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U2 - 10.1016/j.amjhyper.2005.06.017
DO - 10.1016/j.amjhyper.2005.06.017
M3 - Article
C2 - 16461187
AN - SCOPUS:32344439998
VL - 19
SP - 27
EP - 32
JO - American Journal of Hypertension
JF - American Journal of Hypertension
SN - 0895-7061
IS - 1
ER -