Abstract 2797: Pulse Pressure versus Pulse Wave Velocity for the Detection of Preclinical Left Ventricular Diastolic Dysfunction
BACKGROUND: An age-dependent relationship between aortic and left ventricular stiffening has recently been observed in community-based adults. Our aim was to compare the performances of wave reflection-dependent (pulse pressure) and independent (carotid-femoral pulse wave velocity [PWV]) indexes of aortic stiffness to detect preclinical left ventricular (LV) diastolic dysfunction.
METHODS: In this case-control study, a stratified subsample of participants of a cross-sectional population-based echocardiographic survey with LV ejection fraction (EF)>45% and without overt heart failure were randomly selected to undergo assessment of LV diastolic function by Doppler echocardiography and estimation of central aortic pressures and PWV by applanation tonometry.
RESULTS: Of the 233 subjects (mean age 73 ± 6 years, 54% men), 84 normal diastolic function, 99 had mild diastolic dysfunction, and 50 had moderate or severe diastolic dysfunction. Brachial pulse pressure, central pulse pressure, and PWV progressively increased according to the severity of diastolic dysfunction, independent of age and sex (Table⇓). The overall performance of PWV was superior to brachial pulse pressure (area under receiver operating characteristic curve [AUC]: 0.70 vs. 0.59, respectively; p<0.005) and central pulse pressure (AUC: 0.70 vs. 0.56, respectively; p<0.001) for the detection of any diastolic dysfunction.
CONCLUSIONS: PWV appeared superior to central and brachial pulse pressure for the detection of diastolic dysfunction in older adults with ``preserved” LVEF.