Author + information
- Süleyman Karakoyun1,
- Mustafa Ozan Gürsoy2,
- Kamuran Kalkan3,
- Zakir Lazoğlu3,
- Abdurrezzak Börekçi4,
- Halil İbrahim Tanboğa3 and
- Serdar Sevimli3
The value of conventional non-invasive brachial artery pressure parameters in prediction left ventricular end-diastolic pressure (LVEDP) is vague. In this study, we aimed to investigate any potential relationship between brachial artery fractional pulse pressure (FPP), pulsatility index (PI) and invasive measurement of LVEDP in patients undergoing left heart catheterization due to suspected ischemic heart disease.
In this observational study, a total of 93 patients who underwent coronary angiography due to suspected ischemic heart disease were included. Patients with non-sinus rhythm, chronic obstructive lung disease, acute coronary syndrome, primary pulmonary hypertension, constrictive pericarditis, moderate or severe mitral or aortic stenosis and regurgitation, and those with problems in measurement of LVEDP were excluded. Study population was selected by nonrandomized sampling method. The patients with < LVEDP 18 mmHg constituted the group 1, and >18 mmHg group 2. LVEDP was initially measured invasively by cardiac catheterization. Subsequently, systolic and diastolic pressure along with FPP (pulse pressure/mean pressure) and PI (pulse pressure/diastolic pressure) were measured non-invasively from brachial artery using sphygmomanometer. Informed consent was obtained from each patient.
The mean age of the study population (n=93) was 54±13 (M:48, F:45). There were no significant differences between groups regarding age, gender and atherosclerotic risk factors. The mean invasively measured LVEDP was 17±6.3 mmHg. The noninvasively measured FPP levels were 0.72±0.2 and PI 1±0.39. FPP levels were significantly different between group 1 and 2 (0.65±0.19, 0.81±0.16, respectively, p=0.001), whereas there was no statistical difference in terms of PI (1±0.4, 0,99±0,38, respectively, p=0.980). There was a moderate positive correlation between noninvasively measured FPP and invasively measured LVEDP (r:0.341, p=0.007). No correlation was observed between PI and LVEDP (r:-0.38, p=0.773). ROC curve analysis was performed to detect the best cut-off value of FPP in the prediction of increased LVEDP. FPP value >0.69 yielded an AUC value of 0.720 (95% CI 0.593-0.847) (p:0.003). Furthermore, FPP of >0.69 value demonstrated a sensitivity of 67% and specificity of 69% for the increase in LVEDP.
Noninvasively measured brachial artery fractional pulse pressure has a significant relationship with the invasively measured LVEDP.