Abstract 10622: Radial Augmentation Index: A Useful Indicator of Left Ventricular Diastolic Function in Patients with Hypertension

Abstract

Background: Left ventrifular (LV) diastolic dysfunction is an increasingly prevalent disease process in practice. It is commonly associated with hypertension, advancing age, insulin resistance and type 2 diabetes. Increment of LV afterload has been suggested as a significant contributor to the LV diastolic dysfunction. Radial augmentation index (r-AI) is an indicator of arterial stiffness and reflects the LV afterload.

Objectives: The aim of this study is to examine the association of r-AI with LV diastolic function by assessing non-invasive indices derived from Doppler echocardiography in patients with hypertension.

Methods and Results: A total of 107 hypertensive patients(mean age: 68±12 years) without any structural heart disease or LV systolic dysfunction, followed-up in an outpatient clinic, were analyzed in a cross-sectional study. Applanation tonometry of the radial artery and two demensional Doppler echocardiography to estimate LV diastolic function were performed simultaneously. The correlation of r-AI with early diastolic mitral annular (e') velocity and transmitral to early diastolic mitral annular velocity ratio (E/e') were significant (r=-0.45, p<0.0001; r=0.47, p<0.0001)(figure 1). We divided patients into four groups based on r-AI level (median value =0.88) and the coexistence of diabetes mellitus (DM). Although brachial systolic blood pressure were comparable among four groups, the e' velocity in the higher r-AI and DM group was significantly lowest among four groups (5.3±1.3 cm/s, p<0.0001)(figure 2).

Conclusions: The r-AI correlates significantly with the parameters representing LV diastolic function in patients with hypertension. It is useful and feasible indicator for LV diastolic dysfunction, especially in hypertensive patients with DM.