PP.18.03

Abstract

Objective: For a long time it was believed that the development of left ventricle diastolic dysfunction (LV DD) in patients with AH is the result of LVH. We were interested to investigate the profile of diastolic function (DF) in patients with impaired arterial stiffness (AS) and very mild LVH, and associate them with ventricular-arterial coupling (VAC). Design and method: 67 patients with essential AH were included (mean SBP 157,57 ± 5,46 mmHg, mean DBP 92,13 ± 2,87 mmHg; BMI 28,99 ± 0,99; age 52,77 ± 3,59), 33 men and 34 women without symptoms of heart failure. The following diagnostic procedures were performed: office BP measurement, measurement of central BP (cSBP) and adjusted augmentation index (Alx75%), carotid-femoral (cfPWV) pulse wave velocity, Doppler EchoCG, LV DD was determined by measuring E and peak A of transmitral flow with determination E/A, peak E’ by tissue Doppler with determination E/E’, deceleration time (Dt) and isovolumic relaxation time (IVRT). LV myocardium mass index (LVMMI) was evaluated using ASE formula (we used thresholds of 95 g/m2 for the main group). To assess the relationship between these values we used Spearman correlation analysis. Results: In this group of patients with AH mean cSBP was 142,78 ± 5,85 mmHg. Systolic function (EF 64,07 ± 1,45%) was preserved, indicators of LV DF were also within normal limits, but there was a slight tendency to their impairment (E/A 1,07 ± 0,1; E/E’ 9,07 ± 2,59; Dt 236,58 ± 14,74; IVRT 87,78 ± 6,03), maybe, due to mild LVH (LVMMI 97,50 ± 5,42). Arterial stiffness (cfPWV 12,02 ± 0,78) and ventricular-arterial coupling (VAC 1,59 ± 0,05). were impaired E/A significantly correlated with Alx75% (r = -0,433; p < 0,001) and cfPWV (r = 0,32; p = 0,1). E/E’ correlated with VAC (r = 0,292; p = 0,026), LVMMI (r = 0,55; p < 0,001), Alx75% (r = 0,469; p < 0,001), cfPWV (r = 0,303; p = 0,02). Dt correlated with LVMMI (r = 0,268; p = 0,035), Alx75% (r = 0,317; p = 0,011). IVRT correlated with LVMMI (r = 0,290; p = 0,025), Alx75% (r = 0,430; p = 0,001) and cfPWV (r = 0,270; p = 0,035). We have found no significant correlation between VAC and cfPWV, however VAC was correlated with LVMMI (r = 0,342; p = 0,006). Conclusions: AS significantly correlated with LV DF. AS was impaired as well as VAC but we did not found any significant correlations between them. The strongest correlation was between Alx75% and all of indicators of LV DF.