Increased aortic wave reflection and longitudinal regional diastolic dysfunction in patients with left ventricular hypertrophy

Abstract

ObjectivesIncreased arterial stiffness is associated with the progression of left ventricular hypertrophy (LVH); however, the endocardial layer (End) contracts more than the epicardial layer (Epi), and it is unclear whether increased arterial stiffness affects regional wall deformation in both the End and Epi in LVH. MethodsWe performed echocardiography and measured the radial augmentation index (rAIx) in 41 patients with LVH. We evaluated the longitudinal strain, and early diastolic strain rate (SRdia) (measures of regional wall deformation) in both End and Epi in addition to measures of global diastolic function. The ratios of End strain to Epi strain (End/Epi strain) and End SRdia to Epi SRdia (End/Epi SRdia) were also calculated. ResultsAll of the patients had a decreased LV diastolic function (E/e′>8) and preserved ejection fraction (>45%). The rAIx was slightly related to the End/Epi SRdia (r=0.29, P=0.063); the relationship of rAIx to End/Epi SRdia (beta=0.52, P=0.034) was significant after adjustment for potential confounding factors. The rAIx at heart rate 75 beats per minute (rAIx@HR75) was significantly related to End/Epi SRdia (r=0.36, P=0.023); the relationship of rAIx@HR75 to End/Epi SRdia remained significant even after the adjustment (P=0.032). The relationships of rAIx@HR75 to End/Epi strain did not reach the level of statistical significance (r=0.30, P=0.06) in this study. ConclusionIncreased rAIx, a measure of aortic wave reflection, may be associated with a regional diastolic function in the ratio of endocardial to epicardial layer of the left ventricular wall in patients with left ventricular hypertrophy.