The pulse wave velocity (PWV) has been recognized as a marker of arterial stiffness. Recent studies demonstrated that arterial stiffness has shown to be increased in patients with heart failure with preserved ejection fraction (HFpEF) and may predict as a marker of HFpEF. Aim of this study was to determine the relation between arterial stiffness (PWV) and early mild diastolic heart failure (DHF) in hypertensive patients.Design and Method:
Based on Korean Registry of Target Organ Damages in Hypetension (KorHR), we examined total of 371 patients who had the complete data, including PWV and EF. Arterial stiffness was assessed by PWV. Left ventricular mass index (LVMI) and LVEF were measured by 2D-echocardiography. Diastolic function (E/A ratio, Deceleration Time, and E/E′) was assessed by PW-Doppler and tissue Doppler imaging.Results:
The hypertensive patients with preserved EF had higher PWV (15.82 ± 3.0 m/s) in both sex groups (Women: 16.09 ± 3.2 m/s, Men: 15.65 ± 2.8 m/s) when compared to normal values. In this group, women were older than men (53.8 ± 11.1 Vs. 48.1 ± 11.3, p = 0.046). From univariate analysis, age, baseline systolic BP, and history of hypertension medication showed significant association with PWV, however, sex, diabetes and dyslipidemia were not statistically significant. In single regression analysis, PWV was positively associated with age (r = 0.35, < 0.001), LVMI (r = 0.11, p = 0.019), E/E′ (r = 0.14, p = 0.004), significantly lower E/A (r = −0.27, p < 0.001) and prolonged Deceleration Time (DT, r = 0.18, p < 0.001). In multivariate analysis, E/A (r = −0.16, p = 0.004) and age (r = 0.14, p = 0.011) were independent predictors even after adjusting covariates.Conclusions:
In our study, increased arterial stiffness was associated with early mild DHF (lower E/A ratio) in hypertensive patients independently of age, gender, DM, dyslipidemia, LVMI, E/E′, DT, and a history of hypertension medication. PWV as a non-invasive technique may allow serial assessment of hypertensives and can provide the information about the patients who needed more intensive therapy.