Impact of Brachial-Ankle Pulse Wave Velocity on Myocardial Work by Non-invasive Left Ventricular Pressure-Strain in Non-hypertensive and Hypertensive Patients With Preserved Left Ventricular Ejection Fraction

Abstract

ObjectiveData regarding the influence of arterial stiffness on myocardial work (MW) has been scarce. This study was performed to investigate the association between brachial-ankle pulse wave velocity (baPWV) and MW by non-invasive left ventricular pressure–strain in a population of non-hypertensive and hypertensive individuals.MethodsTwo hundred and eight participants (104 hypertensive and 104 non-hypertensive individuals) were prospectively enrolled into the study. All participants underwent conventional echocardiography, as well as 2D speckle-tracking echocardiography to assess MW by non-invasive left ventricular pressure–strain and global longitudinal strain (GLS). baPWV measurements were made at the same day as the echocardiography. Then, participants were categorized according to baPWV tertiles. Correlation between baPWV and MW were analyzed. Predicting ability of baPWV for abnormal WM was analyzed using receiver operating characteristic (ROC) curve.ResultsThe median baPWV from the low to high tertile groups were 1286.5 (1197.5–1343.5), 1490.0 (1444.5–1544.0), and 1803.8(1708.3–1972.0) cm/s, respectively. In simple linear regression analysis, baPWV had a significant positive association with global work index (GWI), global constructed work (GCW), and global wasted work (GWW), and a negative association with global work efficiency (GWE). The association remained significant after adjusting for major confounding factors in multiple linear regression analysis. The areas under the ROC curve of baPWV for predicting abnormal GWI, GCW, GWW, and GWE were 0.653, 0.666, 0.725, and 0.688, respectively (all p < 0.05).ConclusionsBaPWV is significantly associated with all four components of MW using non-invasive left ventricular pressure-strain method in a mixed population of non-hypertensive and hypertensive individuals.

Noninvasive left ventricular pressure-strain myocardial work in patients with well-functioning bicuspid aortic valves and aortic dilation: a preliminary study

“…Our study additionally revealed the aortic stiffness index to an independent influencing factor of MW parameters, which persisted even after adjustment for other confounders. The results were consistent with the findings of Duan et al ( 29 ), who reported there to be a significant association between increased arterial stiffness and MW parameters. From another perspective, the relationship between arterial stiffness and MW parameters may facilitate the interpretation of subclinical myocardial function impairment in patients with well-functioning BAV.…”

Fructose‐induced salt‐sensitive blood pressure differentially affects sympathetically mediated aortic stiffness in male and female Sprague‐Dawley rats

“…Additionally, hypertensive individuals had significantly higher brachial PWV and significantly lower GLS compared to the normotensive participants but this study did not assess any sex‐based dichotomy (Duan et al, 2022 ). These data agree with studies in male rats with fructose salt sensitive hypertension showing that aortic stiffness is accompanied by a deficit in myocardial shortening as measured by GLS (Duan et al, 2022 ). The present data indicate that these indices are not deranged in females on fructose and high salt diet, coincides with their failure to increase blood pressure on the fructose high salt diet.…”

“…Indeed, two major meta‐analyses demonstrated that aortic PWV is the most reliable predictor of cardiovascular mortality (Ben‐Shlomo et al, 2014 ; Vlachopoulos et al, 2010 ). A recent study in a mixed population of hypertensive and normotensive individuals showed that those in the highest tertile of brachial PWV had the lowest GLS and the highest proportion of hypertensives (54% vs. 12% and 38% in tertiles 1 and 2, respectively) (Duan et al, 2022 ). Additionally, hypertensive individuals had significantly higher brachial PWV and significantly lower GLS compared to the normotensive participants but this study did not assess any sex‐based dichotomy (Duan et al, 2022 ).…”

“…A recent study in a mixed population of hypertensive and normotensive individuals showed that those in the highest tertile of brachial PWV had the lowest GLS and the highest proportion of hypertensives (54% vs. 12% and 38% in tertiles 1 and 2, respectively) (Duan et al, 2022 ). Additionally, hypertensive individuals had significantly higher brachial PWV and significantly lower GLS compared to the normotensive participants but this study did not assess any sex‐based dichotomy (Duan et al, 2022 ). These data agree with studies in male rats with fructose salt sensitive hypertension showing that aortic stiffness is accompanied by a deficit in myocardial shortening as measured by GLS (Duan et al, 2022 ).…”

Hypertension‐specific association of cardio‐ankle vascular index with subclinical left ventricular function in a Chinese population: Danyang study

“…Finally, the levels of mean CAVI in their study were 8.9 ± 1.4 and 9.7 ± 1.3, respectively, which obvious higher than our study (8.2 ± 1.3). Although two studies using simple correlation analysis reported that baPWV was significantly associated with GLS in 248 subjects without obvious heart disease 23 and in 208 subjects, 24 these two studies could not provide hypertension‐specific and background‐dependent associations because of small sample size and potential confounders.…”