Abstract 3757: Characterizing the Relationship between Aortic Stiffness and Diastolic Function: A Population-based Study of Older Adults
BACKGROUND: Age-related increases in aortic pulse wave velocity (PWV), an index of aortic stiffness, and deterioration in left ventricular (LV) diastolic function are predictive of adverse cardiovascular outcomes. However, there are scant data to document the relationship between these physiologic risk markers in the community.
METHODS: Within a large population-based survey of LV function (Canberra Heart Study), we examined the relationship between aortic PWV and LV diastolic function in a sub-sample of subjects with LV ejection fraction >45% and without valvular heart disease, who were randomly selected according to diastolic function status. Diastolic function was assessed by Doppler echocardiography and aortic PWV was quantified non-invasively by applanation tonometry.
RESULTS: Of the 233 subjects in this substudy (mean age 73 ± 6 years, 54% men), 84 (36%) normal diastolic function, 99 (43%) had mild diastolic dysfunction, and 50 (21%) had moderate or severe diastolic dysfunction. Women had higher age-adjusted levels of brachial pulse pressure (p=0.03), LV filling pressure (p<0.0001) and impaired LV relaxation (p=0.01) by Doppler-echo estimation, and relative LV wall thickness (p=0.01). After adjusting for clinical-echo parameters and brachial blood pressure (Table⇓), age-related deterioration in diastolic dysfunction was independently associated with increasing aortic PWV (odds of diastolic dysfunction were 22% higher with every 1m/s increase in aortic PWV; p=0.001). The overall performance of aortic PWV was superior to brachial pulse pressure for the detection of any diastolic dysfunction (area under receiver operating characteristic curve: 0.70 vs. 0.59, respectively; p=0.005).
CONCLUSION: Age-related deterioration in diastolic dysfunction was associated with increasing aortic PWV. Whether modification of aortic PWV with medical therapy attenuates diastolic dysfunction and cardiovascular risk remains to be determined.