Impact of systolic time intervals on the relationship between arterial stiffness and left ventricular hypertrophy

Abstract

Objectives: Arterial stiffness is correlated with left ventricular hypertrophy (LVH) and is susceptible to left ventricular performance. Therefore, if left ventricular systolic function is unknown, the relationship between arterial stiffness and LVH is controversial. This study was to assess the impact of the ratio of brachial pre-ejection period (bPEP) to brachial ejection time (bET), a marker of left ventricular systolic function, on the relationship between brachial-ankle pulse wave velocity (baPWV) and LVH.

Methods: A total of 1146 patients were included in the study. The baPWV and bPEP/bET were measured using an ABI-form device. Patients were classified into four groups. Groups 1, 2, 3, and 4 were patients with bPEP/bET ≤ 0.38 and baPWV below the median, bPEP/bET > 0.38 but baPWV below the median, bPET/bET ≤ 0.38 but baPWV above the median, and bPET/bET > 0.38 and baPWV above the median, respectively.

Results: Patients in groups 3 and 4 (high baPWV) and patients in group 2 (low baPWV but high bPEP/bET) were associated with increased left ventricular mass index (LVMI) and LVH (all P < 0.001). In a multivariate model, baPWV was significantly associated with LVMI (P = 0.007) and LVH (P = 0.025). Further adjustment for bPEP/bET made the association between baPWV and LVMI (P = 0.150) and LVH (P = 0.173) disappear.

Conclusions: The bPEP/bET has an important impact on the relationship between baPWV and LVH. Therefore, the value of bPEP/bET obtained from the same examination should be considered while interpreting the relationship between baPWV and LVH.