Arterial Stiffness and Left Ventricular Diastolic Function

Abstract

See related article, pp 362–368 Diastolic heart failure with preserved systolic ejection fraction is becoming a major health burden and is responsible for >50% of heart failure hospital admissions.1 Arterial hypertension is one of the most important risk factors for diastolic dysfunction; however, systolic and diastolic blood pressures are the 2 extreme points of the arterial waveform. Arterial stiffness/elasticity derived from the continuous arterial waveform has been the focus of research to expand knowledge of blood pressure with diastolic (dys)function.2 Interestingly, women have a lower arterial elasticity (higher arterial stiffness) than men and tend to develop more diastolic dysfunction than men.3 A consistent finding among population studies is that women significantly outweigh men in this disease in a range of 2:1. In this issue, Russo and coworkers reported their results about sex differences in relationship among arterial stiffness, wave reflections, and left ventricular diastolic function beyond the classical cardiovascular risk factors in the Cardiovascular Abnormalities and Brain Lesions (CABL) study cohort.4 They used applanation tonometry, considering the following hemodynamic parameters: central pulse pressure/stroke volume index, total arterial compliance, pulse pressure amplification, and augmentation index. These parameters of arterial stiffness and wave reflection were greater in women compared with men, independent of body size and heart rate, and showed inverse relationships with parameters of diastolic function in both sexes. Further adjustment for cardiovascular risk factors attenuated these relationships; however, the ratio central pulse …