Title : Peripheral artery disease: A hidden threat to heart function
Abstract:
Background: Peripheral artery disease (PAD) is often linked to heart failure with preserved ejection fraction (HFpEF), a condition characterized by impaired left ventricular (LV) relaxation during diastole. LV diastolic dysfunction is a critical component of HFpEF. This investigation aimed to compare and assess LV diastolic function in individuals with and without PAD.
Methods: In this study, 200 patients (61% male, 39% female, mean age 65±15 years) with preserved LV systolic function (ejection fraction ≥50%) were selected from a single-center cohort between October 2023 and October 2024. PAD was defined by an ankle-brachial index (ABI) <0.9 or a history of lower extremity bypass surgery or endovascular interventions. LV diastolic dysfunction was diagnosed based on the guidelines from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. The prevalence of LV diastolic dysfunction was compared between those with and without PAD. A multivariate logistic regression model was used to identify independent predictors of LV diastolic dysfunction.
Results: Among the 200 participants, 40 (20%) were diagnosed with PAD. Patients with PAD had significantly elevated E/e′ ratios (14.2±6.3 vs 11.2±4.7, p<0.05), higher tricuspid regurgitation velocities (2.34±0.31 vs 2.14±0.26 m/s, p<0.05), and increased left atrial volume indices (38.4±18.9 vs 31.7±13.2 mL/m², p<0.05) compared to those without PAD. Additionally, e′ velocities were significantly reduced in the PAD group (5.42±1.60 vs 6.15±1.90 cm/s, p<0.05). The incidence of LV diastolic dysfunction was notably higher in PAD patients (27% vs 13%, p<0.01). Logistic regression analysis revealed PAD as an independent predictor of LV diastolic dysfunction (adjusted odds ratio: 1.55, 95% CI: 1.02–2.45, p=0.04).
Conclusion: The findings from this study indicate that LV diastolic dysfunction is more prevalent in patients with PAD compared to those without. PAD independently predicts the presence of LV diastolic dysfunction, highlighting the role of PAD in contributing to disturbances in left ventricular relaxation, which may have important implications for cardiovascular care and risk assessment.
