Abstract 12894: The Relations of Central Hemodynamics and Aortic Stiffness With Cardiac Structure and Function: The Framingham Heart Study

Abstract

Introduction: Relations of steady and pulsatile components of central hemodynamics and aortic stiffness with cardiac dimensions and function have not been fully elucidated. Methods: We measured mean arterial pressure (MAP, steady component of blood pressure), central pulse pressure (CPP, pulsatile component of central blood pressure), and carotid-femoral pulse wave velocity (CFPWV, a measure of aortic stiffness) by arterial tonometry in 5799 Framingham Heart Study participants (mean age 51 years, 54% women). We related these to echocardiographic left ventricular (LV) dimensions and systolic and diastolic function using multivariable-adjusted partial Pearson correlations. Results: MAP was associated positively with LV wall thickness (r=0.168; p<0.0001) and LV diastolic dimension (r=0.035, p=0.006). Adjusting for MAP, CPP was positively associated with LV wall thickness and LV diastolic dimension (r=0.044 and r=0.080, both p<0.0001). CFPWV was not associated significantly with LV structure (all p≥0.27) in MAP-adjusted models. MAP and CFPWV were associated negatively with LV diastolic function (E’; r=-0.140 and r=-0.153, respectively; both p<0.0001). The MAP relation persisted after adjustment for LV mass and CPP (r=-0.142) and the CFPWV relation persisted after adjustment for LV mass and MAP (r=-0.108, both p<0.0001). MAP and CFPWV were not associated significantly with LV fractional shortening (p≥0.10), whereas CPP was positively related (r=0.064, p<0.0001). The figure shows adjusted LV diastolic dimension (Panel A) and LV wall thickness (Panel B) partioned by tertiles of MAP and CPP, and E’ partitioned by CFPWV tertiles (Panel C). Conclusions: Steady and pulsatile components of central pressure are jointly yet differentially related to LV structure and function. Higher CFPWV is related to reduced LV diastolic function, but not systolic function.