Predictive value of brachial-ankle artery pulse wave velocity to heart failure with preserved ejection fraction in hospitalised patients with acute dyspnoea

Objective: To explore the predictive value of the brachial-ankle artery pulse wave velocity (baPWV) for heart failure with preserved ejection fraction (HFpEF).

Methods: Echocardiographic data, B-type natriuretic peptide (BNP) level, and baPWV were assessed in 111 consecutive patients admitted for acute dyspnea. The patients were divided into the HFpEF group (n=71) and the control group (n=40).

Results: Multivariate logistic regression analyses revealed that the ratio of the early mitral inflow velocity to the tissue Doppler velocity (E/e’) at the lateral mitral annulus, BNP, and baPWV were independently predictive of HFpEF. Adding the baPWV to E/e’ at the lateral annulus and to the BNP resulted in an increase in the area under the curve (AUC) to 0.855 (vs. lateral E/e’ alone, P=0.02) or 0.880 (vs. BNP alone, P=0.02), respectively. The AUC of the three combining indicators including the lateral E/e’, BNP, and baPWV was 0.910 (vs. E/e’ lateral alone, P<0.001; vs. BNP alone, P=0.001). The diagnostic accuracy was improved significantly after adding the baPWV to the diagnostic criteria of the 2007 ESC consensus statement (net reclassification improvement 0.127, P=0.02).

Conclusions: Adding the baPWV to the current diagnostic indicators of the 2007 ESC consensus statement could increase the accuracy of predicting HFpEF.