PP.24.09] THE ROLE OF STRUCTURAL AND FUNCTIONAL ALTERATIONS OF LARGE ARTERIES IN VENTRICULAR HYPERTROPHY AND DIASTOLIC DYSFUNCTION IN PATIENTS WITH ESSENTIAL HYPERTENSION

Abstract

Objective: The aim of the study was to evaluate the influence of structural and functional alterations of large arteries on left ventricular hypertrophy and diastolic dysfunction in hypertensive patients. Design and method: Individuals with essential hypertenstion without any signs and symptoms of diastolic heart failure (n = 98, age 40–70 years, mean age: 55.1 ± 8.8 years, 42% females) were included in the study. Excluding criteria were: any other cardiovascular disease, diabetes and renal impairment with eGFR < 60 ml/min/m2. Applanation tonometry was used to determine central aortic pressures: cSBP, cDBP, Pulse Pressure (PP), Augmentation Index (AIx) and carotid-femoral pulse wave velocity (PWV). Intima media thickness of common carotid artery was measured by multiarray echotracking system. Echocardiography was used to assess left ventricular mass index (LVMI) and diastolic dysfunction: mitral peak E and A wave velocity, E/A ratio, Deceleration Time of peak E wave velocity (DecT), isovolumetric relaxation time (IVRT), pulsed wave TDI mitral e’ and a’ velocity, E/e’ ratio, pulmonary veins systolic (S) and diastolic (D) velocity, S/D ratio, atrial reversal velocity in pulmonary veins (Ar v) and left atrium volume index (LAVI). Results: IMT was negatively correlated with E/A ratio (r = −0.22, p < 0.05), septal e’ (r = −0.3, p < 0.05) and lateral e’ (r = −0.21, p < 0.05), however it was not related to LVMI. PWV was significantly related to LAVI (r = 0.29, p < 0.05), E/A ratio (r = −024, p < 0.05), lateral e’ (r = −0.17, p < 0.05), Ar v (r = 0.31, p < 0.05) and to LVMI (r = 0.30, p < 0.05). There was significant relationship between cSP and septal e’ (r = −0.26, p < 0.05), E/e’ ratio (r = 0.32, p < 0.05) and Ar v (r = 0.32, p < 0.05). Whereas, cDP was only correlated with Ar v (r = 0.28, p < 0.05). Central PP was significantly associated with E/A ratio (r = −0.28, p < 0.05) and septal e’ (r = −0.26, p < 0.05). There was negative correlation of AIx and E/A ratio (r = −0.28, p < 0.05), septal e’ (r = −0.27, p < 0.05, lateral e’ (r = −0.38, p < 0.05) and positive correlation with E/e’ ratio (r = 0.30, p < 0.05) Central aortic pressures were not associated with LVMI. Conclusions: All structural and functional measurements of large arteries relate to diastolic dysfunction and might be usefull to detrmine it at preclinical stage. Only PWV was associated with LVMI.