Correlation And Diagnostic Value Of Pulse Wave Velocity And Cardiac Structure And Function In Heart Failure With Preserved Ejection Fraction

Objective To investigate the correlation and diagnostic value of pulse wave velocity and cardiac structure and function in heart failure with preserved ejection fraction.Methods A total of 398 patients who were admitted to the first ward of the Department of Geriatrics of Lanzhou University First Hospital due to symptoms of heart failure were included.According to the criteria,the included patients were divided into heart failure group with preserved ejection fraction(n=169)and control group(n=229),Measurement includes indicators such as echocardiogram,blood routine,blood biochemistry,N-terminal pro-B-type natriuretic peptide(NT-Pro BNP)and arterial pulse wave velocity(PWV).Correlation analysis,binary logistic regression,receiver operating characteristic curve(ROC curve)and other methods are used to evaluate the correlation between pulse wave propagation velocity and cardiac structure and function,and the addition of pulse wave propagation velocity indicators and whether it can improve the ejection fraction The diagnostic efficiency of conserved heart failure.Results The pulse wave propagation speed of the heart failure group with preserved ejection fraction was significantly faster than that of the normal control group,and the pulse wave propagation speed was significantly correlated with the occurrence of cardiovascular events.After correlation analysis,the carotid-femoral pulse wave propagation velocity(CF-PWV)and the dorsal cervical-foot artery pulse wave propagation velocity(CD-PWV)are respectively related to the maximum velocity of the mitral annulus and ventricular septum in the early diastole(E’S),The maximum velocity of the mitral annulus side wall(E’L),right ventricular diameter(RV),and right atrial diameter(RA)in the early diastole were significantly negatively correlated,and it was more obvious in patients with heart failure with preserved ejection fraction.After binary Logistic analysis,early diastolic mitral valve blood flow velocity/early diastolic mitral valve annulus velocity(E/E’)(sensitivity 65.6%,specificity 98.3%),NT-Pro BNP(sensitivity 96.1%,Specificity 94.7%),CF-PWV(sensitivity 78.1%,specificity 69.4%)and left atrial volume index(LAVi)(sensitivity78.7%,specificity 63.8%)have independent predictive value for heart failure with preserved ejection fraction.The area under the ROC curve of CF-PWV combined with E/E’,NT-Pro BNP and LAVi was significantly higher than the single index(P<0.05).The addition of CF-PWV to the 2019 European Society of Cardiology(ESC)consensus can improve the diagnostic efficiency of this standard for heart failure with preserved ejection fraction.Conclusion Increased pulse wave propagation velocity affects left ventricular diastolic function and right ventricular and right atrium volumes.Carotid-femoral pulse wave propagation velocity combined with existing diagnostic indicators and standards can improve the diagnostic efficiency of heart failure with preserved ejection fraction.