Abstract 3000: Pulse Pressure - An Independent Predictor Of Left Ventricular Hypertrophy In Patients With Asymptomatic Aortic Stenosis. A SEAS Substudy.
Background: Higher pulse pressure (PP) is a marker of higher cardiovascular risk (CV) in general as well as in hypertensive populations and associated with left ventricular hypertrophy (LVH) and artery stiffness. Less is known about the association between PP and LVH in patients with asymptomatic aortic stenosis (AS).
Methods: Baseline PP and LV structure was measured in 1776 patients with asymptomatic AS (peak transaortic velocity 2.5 – 4.0 m/sec) randomized in the Simvastatin Ezetimibe in Aortic Stenosis (SEAS) study. The population was grouped by median PP (60 mmHg) into groups with higher (n=842, mean PP 78 mmHg) or lower PP (n=931, mean PP 49 mmHg). LVH was defined as LV mass/body surface area >104g/m2 in women and >116g/m2 in men.
Results: Patients with higher PP had higher LV wall thicknesses, LV mass, total peripheral resistance and PP/stroke index ratio, were older and shorter, and included more women and patients with aortic regurgitation, LVH and history of hypertension (all p<0.01). LV ejection fraction or degree of AS did not differ between the groups. In multivariate logistic regression analysis, PP was associated with LV hypertrophy independent of significant associations between LVH and gender, degree of AS, and concomitant hypertension or aortic regurgitation (Table 1⇓).
Conclusions: Higher PP is associated with LVH in patients with asymptomatic AS, independent of other well-known covariates of LV mass. Whether higher PP also is a marker of higher CV risk in asymptomatic AS will be assessed in the prospective follow up of the SEAS study population.