RELATIONSHIP BETWEEN ARTERIAL STIFFNESS AND DIASTOLIC FUNCTION IN POST-MENOPAUSAL WOMEN: PP.31.228

Abstract

Objective: Cardiovascular risk in post-menopausal women is related not only to the prevalence of traditional risk factors but also to the incidence of alterations in cardiovascular function and structure. Arterial stiffness can represent a mechanism involved in development of cardiac alterations. The aim of this study is to evaluate the relationship between arterial stiffness and left ventricular diastolic function in a group of post-menopausal women entering the prevention program “Woman and Heart”. Design and Methods: In 149 women with no previous cardiovascular events (age 56 ± 6 years, blood pressure-BP 129 ± 17/76 ± 9 mmHg, 38% hypertensives, 30% smokers, 27% hypercholesterolemic, 20% obese, 8% with impaired glucose tolerance or diabetes), carotid-femoral pulse wave velocity (PWV) was measured by applanation tonometry (Sphygmocor, Atcor Medical). Moreover, a trans-toracic echocardiographic study was carried out to measure mitral inflow pattern, left ventricular mass index (LVMI) and relative wall thickness (RWT). Results: In the total population, carotid-femoral PWV was 7.2 ± 1.3m/s. Left ventricular hypertrophy (LVMI >51 g/m2,7) was found in 30% of the population, RWT was>0.42 in 12%, while impaired left ventricular relaxation (E/A ratio < 0.8, deceleration time>200ms) was found in 24%. An increased PWV was associated with the presence of impaired left ventricular relaxation (PWV 7.72 vs 7.15 m/s, p<0.01), but not with left ventricular hypertrophy or concentric remodeling. The only risk factors associated with increased PWV were age, hypertension and altered glucose tolerance. Logistic regression analysis, adjusted for these 3 risk factors, showed that a PWV greater than the median value of 7.1 m/sec was associated with a 2.9-fold greater risk (confidence limits 5–95% 1.11–7.79) of having impaired left ventricular relaxation. Conclusions: In a post-menopausal female population, evaluated in a primary prevention setting, carotid to femoral PWV is associated to mild diastolic dysfunction even after correction for the most important confounders. These data suggest that an increased aortic stiffness could contribute to left ventricular diastolic dysfunction and possibly to diastolic heart failure in post-menopausal women.