ASSOCIATION BETWEEN ARTERIAL STIFFNESS AND LEFT ATRIAL FUNCTION IN PATIENTS WITH HYPERTENSION

Abstract

Objective: The association between arterial stiffness and left ventricle (ventricular-arterial coupling) has been demonstrated by several studies. Left atrial reservoir strain (LARS), one of the indicators of left atrial function, is known to predict prognosis, early diagnosis, and recurrence after an intervention. However, the association between arterial stiffness and LARS is not well studied. Design and method: From August 2021 to November 2022, we obtained data retrospectively from the patients with hypertension visiting a cardiovascular clinic and conducting both exams of transthoracic echocardiography and brachial-ankle pulse wave velocity (baPWV) in a single referral hospital. Patients with significant structural heart disease were excluded. Pearson's correlation analysis was used to analyze the linear correlation between baPWV and LARS. In addition, we used multivariable logistic regression analysis to evaluate the diagnostic performance of LARS to predict increased arterial stiffness. Results: The 202 participants were enrolled in the present study (62.3 ± 14.0 years and 57.7% male). The median baPWV value was 15.6 m/s (interquartile range 13.7 to 18.4). Fifty-four participants (26.7%) had more than 18.0 m/s. Participants with increased arterial stiffness were older and had higher systolic blood pressure, and higher use of calcium channel blocker, but lower level of hemoglobin and estimated glomerular filtration rate. Among echocardiographic parameters, participants with increased arterial stiffness had lower septal e’, but higher septal E/e’, peak velocity of tricuspid regurgitation, and LA volume index. There were no significant differences in systolic parameters, including left ventricular (LV) ejection fraction and LV global longitudinal strain. LARS showed a modest correlation with baPWV (r = -0.320, p<0.001). Participants with increased arterial stiffness had lower LARS than those without (25.0 ± 9.2% vs. 30.4 ± 7.2%, p<0.001). In multivariable logistic regression analysis, LARS was an independent variable affecting increased arterial stiffness with demographic, laboratory, and echocardiographic parameters (adjusted odds ratio 3.41, 95% confidence interval 1.14-10.22, p = 0.029) Conclusions: Increased arterial stiffness measured by baPWV was associated with decreased LA function evaluated with LARS.