PULSE PRESSURE AMPLIFICATION AND AUGMENTATION INDEX IN ASSOCIATION WITH CARDIAC STRUCTURAL AND FUNCTIONAL DAMAGE

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Objective: To investigate and compare the associations of pulse pressure amplification (PPA) and augmentation index (Aix) with asymptomatic cardiac structural and functional damage in an elderly Chinese population.Design and method: 1940 participants (mean age of 71.6 years) were included in the present study. Central blood pressure (BP) parameters were measured by SphygmoCor device. PPA and Aix were calculated as the ratio of central and brachial pulse pressures and the ratio of augmentation pressure and aortic pulse pressure, respectively. Cardiac structural and functional parameters including left ventricular mass index (LVMI), the ratio of peak early diastolic transmitral flow velocity and early diastolic lateral mitral annular velocity (E/Ea), were evaluated using standardized methods. Results: In correlation analysis, both PPA and Aix significantly correlated with LVMI and E/Ea ratio. When PPA and Aix separately put into same multivariate full-mode linear regression models, both PPA and Aix significantly associated with LVMI (regression coefficient [β] = 4.664, per 10% increase of PPA, P < 0.001; β = 1.998, per 10% increase of Aix, P = 0.02) and E/Ea ratio (β = 0.499, per 10% increase of PPA, P < 0.01; β = 0.152, per 10% increase of Aix, P = 0.18). When PPA and Aix both put into same multivariate stepwise linear regression models, only PPA were stayed in the model. When PPA and Aix separately put into same multivariate full-mode logistic regression models, only PPA was significantly associated with left ventricular hypertrophy (Odds ratio[OR]:1.242, 95% confidence interval[CI]:1.026–1.505, per 10% increase of PPA) and dysfunction (OR: 1.407, 95%CI: 1.087–1.820, per 10% increase of PPA). When PPA and Aix both put into same multivariate stepwise logistic regression models, only PPA were stayed in the model. In all multivariate models, brachial systolic BP was included and significantly associated with cardiac damage. Conclusions: PPA showed stronger BP-independent association with cardiac structural and functional damage than Aix.