Ritsuko Kurimoto1, Hirokazu Shiraishi1,4, Takuya Taniguchi2, Asako Otakara1, Naohiko Nakanishi1, Kan Zen1, Takeshi Nakamura1, Tetsuhiro Yamano1, Takeshi Shirayama1, Hitoshi Yaku3, Satoaki Matoba11Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
2North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
3Division of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
4Electronic correspondence: firstname.lastname@example.org
Background and aim of the study: Brachial-ankle pulse wave (ba-PW) analysis is an established technique for assessing arterial stiffness and cardiovascular risk. The peripheral arterial pulse wave configuration may be useful for valvular heart disease (VHD) detection because it is closely related to the physical signs of VHD; however, few reports have been made assessing the efficacy of ba-PW analysis for VHD screening.
Methods: Consecutive VHD patients scheduled for valve surgery were enrolled in the study. These included 58 patients with aortic stenosis (AS) (mean age 74 ± 1.1 years), 67 with aortic regurgitation (AR) (mean age 59 ± 1.9 years), and 65 with mitral regurgitation (MR) (mean age 62 ± 1.6 years). Ba-PW analysis was conducted using the VaSera VS-1500 screening system before and after surgery. Upstroke time (UT), ejection time (ET), pre-ejection period (PEP), PEP/ET ratio, mean arterial pressure (%MAP), and cardio-ankle vascular index (CAVI) were compared with a control group
(n = 65; mean age 69 ± 1.5 years) without VHD.
Results: The UT was significantly shorter in the AR group (132.9 ± 4.0 ms) and MR group (134.5 ± 2.5 ms), but significantly longer in the AS group (178.2 ± 2.8 ms) compared to controls (149.6 ± 3.6 ms; all p <0.01). The ET was significantly longer in the AS group (318.5 ± 7.4 ms) and AR group (320.0 ± 4.6 ms), but significantly shorter in the MR group (289.0 ± 3.8 ms) compared to controls (305.3 ± 3.4 ms; all p <0.05). In ROC analyses of each group compared to controls, areas under the curve of UT, corrected (c)UT, ET and cET in the AS group, UT/ET ratio in the AR group, and PEP/UT ratio in the MR group were all >0.7.Conclusion: Multiple pulse wave parameters reflect VHD hemodynamics and may be useful for screening for the condition.
The Journal of Heart Valve Disease 2018;27:71-77
|Brachial-Ankle Pulse Waves Reflect the Hemodynamics of Valvular Heart Disease|
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