Increased arterial stiffness and wave reflections were inversely correlated with peak systolic velocity (e.g., AIx R=-0.38, P<0.001) and early diastolic velocity (e.g., PWV R=-0.64, P<0.0001).
Observational (n=336)
Are arterial stiffness and wave reflections associated with impaired systolic and diastolic function in patients with normal ejection fraction?
Increased arterial stiffness and wave reflections are independently associated with impaired systolic and diastolic function, as well as functional limitations, in patients with normal ejection fraction.
Effect estimate: R = -0.38
p-value: p=< 0.001
BACKGROUND: Increased arterial stiffness and early wave reflections have been observed in patients with heart failure and normal ejection fraction (HFNEF). We investigated, whether impaired arterial function is associated with impaired systolic and diastolic function and symptomatic status. METHODS: We prospectively enrolled 336 patients (mean age 63.5 years) undergoing coronary angiography, and assessed pulse wave velocity (PWV) invasively, arterial wave reflections (augmentation index (AIx); pressure augmentation (AP)) noninvasively using radial applanation tonometry and a validated transfer function, and characteristic impedance (Zc) using echocardiography with tonometry. In addition, echocardiography including tissue Doppler of the mitral annulus was performed. RESULTS: Peak systolic velocity (S') varied inversely with AIx (R = -0.38, P < 0.001), AP (R = -0.48, P < 0.0001), PWV (R = -0.39, P < 0.001), and Zc (R = -0.29, P < 0.01). Likewise, early diastolic velocity (E') showed a strong, negative correlation with AP (R = -0.32, P < 0.01), PWV (R = -0.64, P < 0.0001), and Zc (R = -0.50, P < 0.0001). Higher filling pressures were associated with increased wave reflections (AIx, AP) and arterial stiffness (PWV, Zc). All associations were independent of age and gender. Patients suffering from exertional dyspnea had increased AIx, AP, and PWV. CONCLUSIONS: In middle-aged and elderly patients, increased arterial stiffness and wave reflections are consistently and independently associated with impaired systolic and diastolic function and with functional limitations.
Weber et al. (Thu,) conducted a observational in Normal ejection fraction (n=336). Arterial stiffness and wave reflections was evaluated on Peak systolic velocity (S') and early diastolic velocity (E') (R = -0.38, p=< 0.001). Increased arterial stiffness and wave reflections were inversely correlated with peak systolic velocity (e.g., AIx R=-0.38, P<0.001) and early diastolic velocity (e.g., PWV R=-0.64, P<0.0001).