Abstract 688: Increased Carotid Artery Plaque Burden is Associated With Reduced Left Ventricular Function in Asymptomatic Individuals
Introduction Carotid artery disease is closely related to reduced myocardial flow reserve. We sought to establish whether carotid atherosclerosis is associated with incipient left ventricular (LV) dysfunction in subjects without manifest cardiovascular disease (CVD).
Methods We studied 2,254 healthy subjects recruited from the LOLIPOP (London Life Sciences Prospective Population) study. Bilateral carotid ultrasonography was performed on all subjects to determine presence of carotid plaque, with the total number of plaques identified providing a plaque score. Subjects with a plaque score of 0, 1–2, 3–5 and > 5 were classified as having no, mild, moderate and severe plaque burden respectively. Tissue Doppler imaging was performed on all subjects for derivation of parameters of LV longitudinal function and filling pressure (myocardial Sa velocity, myocardial Ea velocity and the E/Ea ratio).
Results Subjects with higher plaque score were older, more likely to be male, have a greater prevalence of hypertension, diabetes and history of cigarette smoking (ANOVA and test for trend, all p<0.001). After adjustment for age, gender, race, pulse pressure, antihypertensive therapy, diabetes, body mass index, smoking and LV mass index, subjects with a severe plaque burden had reduced LV systolic and diastolic function compared to controls (figure⇓). Mild, moderate and severe plaque burden categories were each associated with significantly higher LV filling pressure compared to controls after multivariate analysis (figure⇓).
Conclusion This study confirms a direct relationship between severity of carotid artery disease and reduced LV function in subjects without clinical CVD.