Association of left ventricular diastolic function with parameters of arterial stiffness and atherosclerotic plaques in the carotid basin in hypertensive patients

Abstract

Aim. Тo assess changes in the left ventricular diastolic dysfunction (LVDD) indicators depending on the elastic properties of the common carotid arteries (CCA) and the presence of atherosclerotic plaque (ASP) in patients with stage II hypertension (HTS). Materials and methods. 48 patients with stage II HTS were involved in the study, the average age was 55.9 ± 11.2, 45.8 % men, among whom 14 did not have LVDD, 34 – had type I LVDD; 25 people did not have ASP, 23 people had ASP. Basic anthropometric data, echocardiographic indicators, QIMT, local stiffness indicators were studied: arterial diameter, distensibility, DC, CC, stiffness indices α, β, local PWV, augmentation pressure and index (using RF-QIMT, RF-QAS technologies). Statistical analysis was performed, the probability of differences is at the level of p < 0.05. Results. Significant differences in the stiffness parameters of the common carotid arteries were observed in patients with stage II HTS with LVDD: the diameter of the artery is higher by 6.5 % (p = 0.032), the stiffness index α – 28.3 % (р = 0.008), stiffness index β – 28.1 % (р = 0.009), PWV – 9.8 % (р = 0.004), DC is lower by 50.0 % (р = 0.021). A negative correlation of average strength was observed between e’med, e’lat, e’tv and stiffness indices α, β and PWV; E/e’, e’lat, e’tv had the average strength positive correlation with DC, CC indicators. The diameter of the carotid artery had a positive medium strength correlation with the thickness of the IVS (r = +0.38), LVFW (r = +0.47), RWT (r = +0.32), and LVMI (r = +0.57), diameter of the LA (r = +0.50) and had significant differences between 4 types of LV remodeling. The odds ratio of ASP in CCA increases by 1.32 times (p = 0.038) in the case of an excess of a’med more than 7 cm/c (sensitivity 95.7 %, specificity 28.0 %, p = 0.038); the influence of factor increases with a simultaneous increase in the diameter of the CCA over 7.94 mm (sensitivity 59.1 %, specificity 81.6 %, p = 0.005), and this prognostic model does not depend on age andgender. Conclusions. In persons with stage II HTS, the presence of type I LVDD is associated with an increase in the local stiffness and diameter of the CCA, just as the presence of ASP is associated with worse indicators of LVDD, in particular, a significant increase in a’med, regardless of age and gender.