Abstract 14948: Diastolic Blood Pressure Relates to Incipient Lv Systolic Dysfunction by Speckle Tracking Myocardial Imaging: A 25-Year Follow-Up Study of the Cardia Cohort

Abstract

Background Hypertension is a well known risk factor for incident heart failure. Early recognition of subclinical left ventricular (LV) systolic dysfunction is crucial for preventive efforts. Recent advances in Speckle Tracking Echocardiography (STE) offer the opportunity to assess incipient subclinical markers of LV systolic dysfunction. We studied LV myocardial strain by STE as a marker of subclinical LV dysfunction, secondary to hypertension in the CARDIA cohort. Methods CARDIA participants with available myocardial speckle tracking data at Year-25 were included. Multivariable analysis was used to assess the association between baseline diastolic (DBP) and systolic (SBP) blood pressure and changes in DBP and SBP between baseline and Year-25 with LV global longitudinal peak systolic strain (PSS) by STE at Year-25. We adjusted for age, gender, race, baseline body weight, height, diabetes, smoking status, treatment for hypertension, change in weight during follow-up, and Year-25 heart rate. Results A total of 1,545 participants were included; 55.1% males and 51.3% African American. Mean age at baseline was 25.1±3.6yrs. Mean PSS was -14.3±2.6%. In the multivariable analysis (Table), PSS at Year-25 was reduced (lesser negative value; i.e., less function) with baseline DBP, change in DBP, and baseline hypertension treatment, but unrelated to baseline SBP and change in SBP. Conclusions Diastolic blood pressure is correlated with reduced global longitudinal strain as an incipient marker of subclinical LV dysfunction. In early adulthood, blood pressure control may be of particular importance for the prevention of LV myocardial dysfunction and heart failure.