INTERDEPENDENCE BETWEEN LEFT VENTRICULAR DIASTOLIC DYSFUNCTION AND ARTERIAL ELASTICITY ALTERATION

Abstract

Objective: In HT, both arterial elasticity of the central arteries (C1) and of the distal circulation (C2) has been reported to be reduced and this condition favours the development of other cardiovascular diseases. Diastolic dysfunction (DD) identifies hypertensives with high cardiovascular risk independent of LV mass and BP level. Several studies have shown that the extent of diastolic function's impairment could be interdependent on the level of arterial elasticities’ alteration. PURPOSE: To evaluate the correlation between the elasticity of large and small arteries and DD Design and method: Arterial elasticity indices (C1, C2) were derived from pulse wave analysis based on a modified Windkessel model in 101 hypertensive subjects, (mean age 51.08 ± 0.79 yrs; 48.51% of men, SBP/DBP: 202.49 ± 7.41/106.7 ± 5.54 mmHg, BMI- 29.38 ± 0.22 kg/m2), without other co-morbidities. Ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography (TE)were performed at baseline and after 6, 12- months period of treatment. DD patterns were appreciated according to ASE/EACVI 2016 guidelines. Altered arterial elasticity was considered for C1 < 10 ml/mm Hg × 10, C2 < 6 ml/mm Hg × 1. Correlation analysis was performed using Pearson's test. The correlation coefficient was considered weak at < 0.3, medium-0.3–0.7 and strong > 0.7–1.0. Statistical significance was appreciated at a P-value < 0.05 and highly significant at a P-value < 0.001 Results: Diastolic dysfunction and C1 and C2 indices demonstrated a statistically significant correlation (p < 0.001). More advanced patterns of diastolic dysfunction were associated with higher C1 and C2 abnormalities (Tab. 1,). Conclusions: Diastolic dysfunction is associated with arterial elasticity's alteration, and this association appears to have a particularly strong relationship with the extent of diastolic function's impairment. The more advanced patterns of diastolic dysfunction occurred, the stronger is the interdependence with arterial elasticity abnormalities.