Impact of Pulse Wave Velocity and Parameters Reflecting Android Type Fat Distribution on Left Ventricular Diastolic Dysfunction in Patients with Chronic Coronary Syndromes.

Marlena Paniczko,Katarzyna Ptaszyńska-Kopczyńska,Magda Łapińska,Andrzej Raczkowski,Marcin Kondraciuk,Małgorzata Chlabicz,Anna Szpakowicz,Paweł Sowa,Jacek Jamiołkowski,Małgorzata Szpakowicz,Karol Adam Kamiński

doi:10.3390/jcm9123924

Marlena Paniczko, Katarzyna Ptaszyńska-Kopczyńska + Show 9 more

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https://doi.org/10.3390/jcm9123924

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Abstract

Background: Left ventricular diastolic dysfunction (LVDD) is caused by a decreased left ventricle relaxation and is associated with an increased risk of symptomatic heart failure (HF) and excessive mortality. Aim: To evaluate the frequency and factors related to LVDD in the population with chronic coronary syndromes (CCS). Methods: 200 patients (mean age 63.18 ± 8.12 years, 75.5% male) with CCS were included. LVDD was diagnosed based on the recent echocardiography guidelines. Results: LVDD was diagnosed in 38.5% of CCS population. From the studied factors, after adjustment for age, sex, and N-terminal pro-brain natriuretic peptide (NT-proBNP), LVDD associated positively with android/gynoid (A/G) fat mass ratio, left ventricular mass index (LVMI), and negatively with Z-score and left ventricular ejection fraction (LVEF). In stepwise backward logistic regression analysis, the strongest factors associated with LVDD were pulse wave velocity value, handgrip strength and waist to hip ratio (WHR). Conclusions: LVDD is common among CCS patients and it is associated with parameters reflecting android type fat distribution regardless of NT-proBNP and high-sensitivity troponin T concentrations. Deterioration in diastolic dysfunction is linked with increased aortic stiffness independently of age and sex. Further studies evaluating the effects of increasing physical fitness and lowering abdominal fat accumulations on LVDD in CCS patients should be considered.

Highlights

Left ventricular diastolic dysfunction (LVDD) is caused by a decreased left ventricle (LV) relaxation or increased LV stiffness [1]
We aimed to evaluate the frequency and factors related to left ventricular diastolic dysfunction (LVDD) in the population with chronic coronary syndromes (CCS)
The pulse wave velocity (PWV) value was significantly higher (p = 0.003) in the group with LVDD, but there were no differences between the groups in terms of blood pressure (BP), central blood pressure (CBP), and augmentation index

Summary

Introduction

Left ventricular diastolic dysfunction (LVDD) is caused by a decreased left ventricle (LV) relaxation or increased LV stiffness [1]. Asymptomatic mild LVDD is found in 21% of the population, moderate or severe LVDD is present in 7% and is associated with an increased risk of symptomatic HF and mortality [3]. Chronic coronary syndromes (CCS) are one of the forms of the coronary artery disease (CAD), characterized by accumulation of the atherosclerotic plaques in epicardial coronary arteries They exclude situations in which an acute coronary artery thrombosis dominates the clinical presentation (which are acute coronary syndromes) [6]. Left ventricular diastolic dysfunction (LVDD) is caused by a decreased left ventricle relaxation and is associated with an increased risk of symptomatic heart failure (HF) and excessive mortality. Further studies evaluating the effects of increasing physical fitness and lowering abdominal fat accumulations on LVDD in CCS patients should be considered

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