06.02 Relation of Aortic Stiffness with Echocardiographic Indices of Left Ventricular Diastolic Filling and Longitudinal Velocities in Subjects Free of Clinical Cardiovascular Disease

Abstract

Introduction

a relation between aortic stiffening (AS) and LV systolic dysfunction and hypertrophy is established in the elderly. A relation between AS and LV diastolic function can be hypothesized, mediated by age and increased LV mass (LVM).

Aim

to verify whether AS may affect LV diastolic function independently of LVM and age in subjects with preserved systolic function.

Methods

144 subjects below 65 years, (59 controls: age 40 ± 12, MBP 84 ± 7 mmHg; and 85 patients with at least one major risk factor, free of CV disease, age 42 ± 16, mean BP 96 ± 12 mmHg). LV mass, systolic function, diastolic filling were assessed by Echo-Doppler. Early and late diastolic mitral annulus longitudinal velocities (E’ and A’) were assessed by tissue velocity imaging. AS was estimated by carotid-femoral pulse wave velocity (PWV).

Results

compared to controls, patients had higher (p < 0.05–0.001) PWV (9.4 ± 2 vs 8.0 ± 1 m/s) and lower transmitral E/A ratio (1.2 ± 0.5 vs 1.4 ± 0.4, p < 0.01); no significant differences were found for LV midwall shortening (116±13 and 119 ± 13%), and EF (67 ± 6 and 69 ± 5%). In the overall population, transmitral E/A correlated inversely (p < 0.01) with age (r = -0.60), SBP (r = -0.37), DBP (r = -0.50), LVMI (r = -0.43), and PWV (r = -0.51). In multivariate analysis, PWV remained independent predictor of E/A, together with age, SBP and DBP (adjusted R² 0.43, p < 0.05). E’/A’ showed a similar correlation pattern as E/A. Conclusion: in subjects free of CV disease and with preserved LV systolic function, AS affects LV diastolic filling and longitudinal myocardial velocities independently of age, LVM and BP.