P.006 Measurement of Arterial Pulse Wave Velocity Support the Suspicion of Asymptomatic Left Ventricular Dysfunction in Hypertensive Patients with Metabolic Syndrome or Diabetes Mellitus

Abstract

Background

The aim of this study was to evaluate myocardial function and vascular wall elasticity using pulse wave velocity (PWV) between aorta and femoral artery in patients with hypertension and metabolic syndrome (MS) or type 2 diabetes mellitus (HT +DM).

Methods

Fifty – thre patients (pts) with MS (age: 45,6 years body mass index (BMI): 31,75, blood pressure (BP) 150/94 mmHg and 57 pts with HT and DM type 2 (HT + DM) – (age: 62,9 years, BMI : 30,34, BP 156/101 mmHg and normal renal function were studied. LV function was assessed by brain natriuretic peptide plasma levels (BNP and NT pro BNP), echocardiographically detected ejection fraction (EF), pulsed doppler assessment of transmitral blood flow velocities (E, A, E/A ratio) and pulsed doppler tissue imaging (TDI) of velocities of mitral annular movements (Svm, Evm, Avm).

Results

Pts in both groups revealed normal systolic function of the LV (EF 65 % versus 61%) , pts with HT + DM had higher values of the LV mass than the group with MS (44,9 v.s. 54,0 g/height^2,7, pZ0.005) Average values of PWV were lower in the group with MS than in HT + DM group (11,38m/s vs 12,79 m/s, pZ0.002) as well as BNP (54,7 vs 141,12 pg/l, pZ0.005) and NT pro BNP(66,5 vs 279,6 pg/l). In both groups of pts increased PWV was significantly correlated with TDI measurements indicating reduced diastolic function (PWV and E/Evm r Z 0,698, p<0,001) and values of natriuretic peptides (PWV versus NT pro BNP r Z 0,776, p<0,001).

Conclusions

Arterial stiffness in hypertensive pts revealed some relation to the LV dysfunction. The measurment of the PWV may contribute to the prediction of LV diastolic dysfunction in hypertensive pts with metabolic syndrome or diabetes mellitus.