Presence of diastolic dysfunction in patients with peripheral artery disease.

Peripheral artery disease (PAD) and heart failure (HF) share many risk factors; however, the prevalence and characteristics of HF in patients with PAD have not been fully examined. We investigated 120 consecutive patients with PAD, defined by an ankle-brachial index ≤ 0.9. In all, 36 (30%) patients had brain natriuretic peptide (BNP) levels ≥ 100 pg/mL (high BNP group), and 84 (70%) patients had BNP levels < 100 pg/mL (low BNP group). Univariate analysis showed that high BNP was associated with age, estimated glomerular filtration rate, hypertension, and transmitral E-wave/early diastolic mitral annular velocity (E/e') ratio. Multivariate logistic regression analysis established that a high BNP was strongly and independently associated with the highest quartile of E/e', highlighting these patients' diastolic dysfunction. The prevalence of high BNP levels in patients with PAD suggests that routine BNP measurements might be useful to detect HF.