Increased pre-ejection period to ejection time (PEP/ET) obtained by pulse wave measurements is known to be associated with reduced cardiac function. However, PEP/ET and left ventricular function have not been studied in detail in patients at cardiovascular risk.
Eight hundred and sixty-one patients enrolled in the Coupling study and underwent echocardiography were included. We measured brachial-ankle pulse wave velocity, and estimated the PEP/ET ratio. Left ventricular ejection fraction (LVEF) was measured by echocardiography and classified as normal (LVEF≥ 60%, N = 706), heart failure with preserved ejection fraction (HFpEF: LVEF 51–60%, N = 105), heart failure with mid-range ejection fraction (HFmrEF: LVEF 41–50%, N = 31), heart failure with reduced ejection fraction (HFrEF: LVEF< 40, N = 19), and the relationship between cardiac function and PEP/ET was examined.
PEP/ET and EF was significantly inversely associated with PEP/ET (R = -0.33, p < 0.001). PEP/ET increased progressively with normal, HFpEF, HFmrHF, and HFrEF (0.32 ± 0.07, 0.37 ± 0.09, 0.40 ± 0.13, 0.46 ± 0.16, ANOVA P < 0.001).The receiver operating characteristic curve predicting LVEF < 60% had a PEP/ET of 0.4 (area: 0.695); PEP/ET ≥ 0.4 was a significant predictor of EF < 60% (odds ratio 5.41, 95% confidence interval 3.54–8.26).
Increased PEP/ET obtained by pulse wave measurements was associated with reduced contractility, and PEP/ET ≥ 0.4 was a significant predictor of reduced cardiac function.