P1.29: Cardio-Ankle Vascular Index, Left Ventricular Systolic Dysfunction and Inappropriate Left Ventricular Mass

Abstract

The relation between carotid-femoral pulse wave velocity (cfPWV) and LV remodeling/dysfunction is confounded by the effect of blood pressure (BP). We evaluated the relationship between cardio-ankle vascular index (CAVI), a less BP-dependent measure of the stiffness constant (β) of the aorta, iliac, femoral and tibial arteries, and prognostically relevant measures of LV structure and systolic function.

In 119 subjects with hypertension or high-normal BP (34% treated; 56±16 years, BP 144/89±21/12 mmHg), we measured CAVI and cfPWV, and LV mass and systolic function at echocardiography.

cfPWV had a direct association with SBP/DBP (r=0.33/0.25, p<0.001/<0.01), while no significant association was found between CAVI and SBP/DBP (r=0.15/−0.02, both p>0.1). Both CAVI and cfPWV had direct univariate relationships with LV mass index (r=0.38, p<0.001; r=0.24, p=0.014). The subjects with inappropriately high LV mass for a given cardiac workload (n=36) had a higher CAVI (9.0±1.7 vs 7.6±1.4, p<0.001), but not a higher cfPWV (8.0±1.7 vs 8.3±2.3, p>0.1). In a multivariate stepwise linear regression model, CAVI was an independent predictor of inappropriate LV mass (β=0.44, p<0.001), along with body mass index. CAVI also showed a negative relation with LV midwall fractional shortening (r=−0.41, p=0.001), which was independent of age, sex, BP, and LV mass in a multivariate analysis.

We conclude that CAVI has a significant association with inappropriately high LV mass and LV systolic dysfunction. Our data suggest that pressure-independent stiffness constant (β), a marker of arterial diastolic-to-systolic stiffening, may have an impact on LV structure and function.