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.