Longitudinal Changes in LV Structure and Diastolic Function in Relation to Arterial Properties in General Population

Abstract

ObjectivesWe assessed to what extent arterial properties measured at baseline and follow-up predict longitudinal alterations in echocardiographic indexes reflecting left ventricular (LV) structure and function. BackgroundSerial imaging studies are needed to clarify the relation of changes in LV structure and function to arterial stiffness. MethodsIn 607 participants (50.7% women; mean age 50.7 years), using echocardiography and Doppler imaging, we measured LV dimensions, transmitral blood flow, and mitral annular tissue velocities at baseline and after 4.7 years. Using applanation tonometry, we assessed central pulse pressure (cPP) and carotid-femoral pulse wave velocity (PWV) at baseline. We regressed longitudinal changes in LV indexes on the arterial stiffness parameters and reported standardized effect sizes as a fraction of SD of LV change. ResultsAfter full adjustment, longitudinal increase in LV septal (standardized effect size: +14.4%; p = 0.0018) and posterior wall (+12.6%; p = 0.0027) thickness was associated with higher baseline PWV, whereas LV internal diameter (-12.4%; p = 0.012) decreased during follow-up with PWV. Consequently, greater increase in relative wall thickness was associated with higher baseline PWV (+17.2%; p <0.0001). Participants with higher baseline PWV had a greater risk to develop or retain LV concentric remodeling during follow-up (odds ratio 1.35; p = 0.028). In addition, in women, baseline cPP predicted a greater increase in LV mass (+22.8%; p = 0.0009) and E/e′ ratio (+36.1%; p <0.0001). ConclusionsProgression to LV concentric remodeling pattern was associated with higher baseline PWV. In women, cPP predicted worsening of LV diastolic function. Our study highlights the importance of arterial properties as mediator of LV concentric remodeling in men and women, and diastolic dysfunction in women.