Abstract 4857: Relationship Between Arterial Stiffness and Cardiac Structure and Function in Patients With Hypertension and Diastolic Dysfunction: The VALIDD Trial
Background: Although both vascular and ventricular stiffness are increased in hypertension, the degree to which these abnormalities are related has not been well characterized
Methods: Echocardiographic measures of LV structure and function were assessed in 384 patients enrolled in the VALsartan In Diastolic Dysfunction (VALIDD) trial with mild hypertension (mean blood pressure 144±16/86±10 and LV hypertrophy < 4%), no heart failure and evidence of diastolic dysfunction, based on Doppler assessment of myocardial relaxation velocities (E′). Arterial compliance was calculated as stroke volume (SV)/pulse pressure (PP) with a lower ratio indicative of reduced compliance. Peak longitudinal systolic strain rate (SR) was measured in all 12 LV segments from 2 and 4 chamber views using speckle tracking.
Results: Arterial compliance decreased with older age, female gender, and systolic pressure. In a multivariate model reduced arterial compliance was independently associated with lower E′ (r=0.22, p<0.001) and longitudinal systolic SR (r=−0.18, p<0.001) and with higher filling pressures (assessed either as E/E′ or as NTproBNP), increased end diastolic instantaneous operative LV stiffness (E/E′ ratio/LV EDV) and with increased LV mass and concentric remodeling [Table⇓].
Conclusion: Even amongst patients with mild degree of hypertension, arterial stiffness is related to abnormalities in LV structure, and diastolic and systolic function. These results suggest that both diastolic dysfunction and arterial stiffness are pathophysiologically linked to end-organ consequences of hypertension.