P68 Usefulness of an Optimal Cut-off in Central Augmentation Pressure for the Detection of Left Ventricular Hypertrophy in Men

Abstract

Background

Recently, we showed an age-related increase in augmentation pressure (AP) measured using Mobil-O-Graph (MOG) in normotensive Japanese individuals. However, AP might be a poor index of wave reflection due to the overlap between the forward wave and reflected wave.

Methods

We enrolled untreated hypertensive patients and patients currently on antihypertensive treatment. For 70 patients (median age, 70.5 years; 34 men), M-mode echocardiography was performed for determination of left ventricular hypertrophy (LVH), while hemodynamic measurements were taken using MOG. We investigated the influence of central hemodynamic parameters on LVH.

Results

Spearman correlation coefficients between various parameters [age, height, systolic blood pressure (SBP), mean BP, diastolic BP, central systolic BP (cSBP), and AP] were calculated for LV mass indexed to body surface area (LVMI; g/m²). In men, age (r = 0.600, p = 0.0002), height (r = −0.495, p = 0.003), SBP (r = 0.423, p = 0.013), cSBP (r = 0.454, p = 0.007), and AP (r = 0.661, p < 0.0001) were correlated to LVMI. In women, cSBP (r = 0.334, p = 0.044) and AP (r = 0.480, p = 0.003) were correlated to LVMI. In men, LVMI (R² = 0.578, p = 0.0001) was significantly associated with AP (β = 1.32 ± 0.56, p = 0.027) in multivariate regression analysis. In women, no significant independent parameter for LVMI was observed. ROC curve analysis was performed to estimate the utility of AP for the detection of LVH (LVMI >115 g/m²) in men. Area under the ROC curve was 0.83 (95% CI: 0.68–0.99). The optimal cut-off point of 12.5 mmHg produced 79.0% sensitivity and 86.7% specificity.

Conclusion

Higher AP showing >12.5 mmHg calculated by MOG was a significant independent predictor of LVH in male hypertensive patients.