Differences in Association of Ejection Duration and Carotid-Femoral Pulse Wave Velocity With Target Organ Damage

Abstract

Objective: Target organ damage (TOD is affected differently by cardiac and vascular function parameters such as ejection duration (ED) and carotid-femoral pulse wave velocity (cfPWV). This study aimed to quantify the relative differences in relationship of TOD with ED and cfPWV. Design and method: The study was conducted in 1254 patients (64.27% males) from Ruijin Hospital (December 2018 to August 2022). All participants provided urine and blood samples and information from medical records. cfPWV was measured using applanation tonometry and leg cuff waveforms (SphygmoCor, AtCor Medical, Sydney, Australia), and ED was obtained from waveform features. TOD was assessed in terms of left ventricular hypertrophy (LVH), microalbuminuria, chronic kidney disease (CKD), and abnormality of carotid intima-media thickness (CIMT). Results: Stepwise linear regression models of cfPWV and ED (individually or together) showed that cfPWV was positively correlated with left ventricular mass index (LVMI) (beta = 0.131, p 0.002) and Log (albumin-creatinine ratio, ACR) (beta = 0.123, p = 0.004), while ED was negatively correlated with LVMI (beta = –0.244, p < 0.001) and positively correlated with the estimated glomerular filtration rate (eGFR) (beta = 0.115, p = 0.003). When cfPWV and ED were added separately or together in multiple stepwise logistic regression models, cfPWV was associated with CKD [odds ratio (OR) = 1.240, 95% confidence interval (CI) 1.055–1.458, p = .009], while ED was associated with LVH (OR = 0.983, 95% CI 0.975–0.992, p < 0.001). In the control group with normal cfPWV (< 10 m/s) and normal ED (range 281-321 ms), LVH was significantly lower in patients with high ED (OR = 0.574, 95% CI 0.374–0.882, p = 0.011), but significantly elevated in those with high cfPWV and low ED (OR = 6.799, 95% CI 1.305–35.427, p 0.023). Conclusions: cfPWV was more strongly associated with renal damage, while ED was more strongly associated with cardiac dysfunction. As an index of arterial stiffness, cfPWV has an influence on wave reflection which can affect and ED, with a combined effect on LVH.