Abstract 3269: Increased Aortic Stiffness is a Risk of Left Ventricular Diastolic Dysfunction Even in Normotensive Subjects
Background: Left ventricular (LV) diastolic dysfunction is considered to be one of the underlying mechanisms of heart failure with normal LV ejection fraction. Recently, incremental value of aortic over brachial pressure in predicting cardiovascular events has been reported in hypertensive patients, indicating the clinical importance of aortic stiffness. However, aortic stiffness is strongly affected from peripheral blood pressure. Accordingly, we sought to investigate the impact of aortic stiffness derived from aortic pulse wave velocity (PWV) on LV diastolic function in normotensive subjects.
Methods: Echocardiographic-Doppler indices on LV diastolic function and aortic PWV were measured in 447 (mean age 56±13 years) subjects in an annual checkup in Arita, Saga, Japan. Asymptomatic normotensive subjects (n=267) were derived from the population. LV diastolic dysfunction was defined as any diastolic dysfunction pattern other than normal pattern determined by trans-mitral flow velocity and mitral annular velocity.
Results: In 295 normotensive subjects, LV diastolic dysfunction was observed in 78 (26%). PWV was higher in the subjects with LV diastolic dysfunction (16.1±4.2 m/s) than in those without LV diastolic dysfunction (13.3±2.9 m/s, p<0.01). In the multivariate logistic regression analysis, PWV was independently associated with LV diastolic dysfunction even after adjustment for age, gender, blood pressure, diabetes, dyslipidemia and smoking (OR 1.19 per 1 m/s increase in PWV, 95%CI 1.03–1.37, p=0.02).
Conclusions: Aortic stiffness is associated with asymptomatic LV diastolic function in normotensive subjects, independent of potential confounding factors. The increase in aortic stiffness is a risk factor of LV diastolic dysfunction even in the absence of hypertension.