Increased aortic stiffness, measured by carotid-femoral pulse wave velocity, was cross-sectionally associated with worse left ventricular global longitudinal strain (B 0.122% strain per SD, P<0.0001).
Cross-Sectional (n=2,495)
Is aortic stiffness associated with worse left ventricular global longitudinal strain in a community-based population free of cardiovascular disease?
Increased aortic stiffness is cross-sectionally associated with worse left ventricular global longitudinal strain, suggesting a direct mechanical link between proximal aortic stiffening and early subclinical cardiac dysfunction.
Effect estimate: B 0.122
p-value: p=<0.0001
BACKGROUND: Aortic stiffness impairs optimal ventricular-vascular coupling and left ventricular systolic function, particularly in the long axis. Left ventricular global longitudinal strain (GLS) has recently emerged as a sensitive measure of early cardiac dysfunction. In this study, we investigated the relation between aortic stiffness and GLS in a large community-based sample. METHODS AND RESULTS: In 2495 participants (age 39-90 years, 57% women) of the Framingham Offspring and Omni cohorts, free of cardiovascular disease, we performed tonometry to measure arterial hemodynamics and echocardiography to assess cardiac function. Aortic stiffness was evaluated as carotid-femoral pulse wave velocity and as characteristic impedance, and GLS was calculated using speckle tracking-based measurements. In multivariable analyses adjusting for age, sex, height, systolic blood pressure, augmentation index, left ventricular structure, and additional cardiovascular risk factors, increased carotid-femoral pulse wave velocity (B±SE: 0.122±0.030% strain per SD, P<0.0001) and characteristic impedance (0.090±0.029, P=0.002) were both associated with worse GLS. We observed effect modification by sex on the relation between characteristic impedance and GLS (P=0.004); in sex-stratified multivariable analyses, the relation between greater characteristic impedance and worse GLS persisted in women (0.145±0.039, P=0.0003) but not in men (P=0.73). CONCLUSIONS: Multiple measures of increased aortic stiffness were cross-sectionally associated with worse GLS after adjusting for hemodynamic variables. Parallel reductions in left ventricular long axis shortening and proximal aortic longitudinal strain in individuals with a stiffened proximal aorta, from direct mechanical ventricular-vascular coupling, offers an alternative explanation for the observed relations.
Bell et al. (2017) conducted a cross-sectional in Free of cardiovascular disease (n=2,495). Aortic stiffness was evaluated on Left ventricular global longitudinal strain (GLS) (B 0.122, p=<0.0001). Increased aortic stiffness, measured by carotid-femoral pulse wave velocity, was cross-sectionally associated with worse left ventricular global longitudinal strain (B 0.122% strain per SD, P<0.0001).