Key result
Increased arterial stiffness, measured by 'one-point' pulse wave velocity, was an independent predictor of grade I left ventricular diastolic dysfunction (P=0.038).
Why the study?
Is increased arterial stiffness associated with grade I left ventricular diastolic dysfunction in asymptomatic patients at risk for heart failure?
Cross-Sectional (n=127)
Is increased arterial stiffness associated with grade I left ventricular diastolic dysfunction in asymptomatic patients at risk for heart failure?
Increased arterial stiffness, specifically 'one-point' pulse wave velocity, is independently associated with early left ventricular diastolic dysfunction in Stage A heart failure patients.
Answers are grounded in this paper and cite their sources.
Suggests early diastolic-arterial stiffness link in Stage A HF; leaves open causal direction and clinical utility.
AIMS: We evaluated the interplay between left ventricular diastolic function and large-artery stiffness in asymptomatic patients at increased risk of heart failure and no structural heart disease (Stage A). METHODS: We divided 127 consecutive patients (mean age 49 ± 17 years) with risk factors for heart failure who were referred to our laboratory to rule out structural heart disease into two groups according to presence (Group 1, n = 35) or absence (Group 2, n = 92) of grade I left ventricular diastolic dysfunction. Doppler imaging with high-resolution echo-tracking software was used to measure intima-media thickness (IMT) and stiffness of carotid arteries. RESULTS: Group 1 had significantly higher mean age, blood pressure, left ventricular mass index, carotid IMT and arterial stiffness than Group 2 (P < 0.05). Overall, carotid stiffness indices (β-stiffness index, augmentation index and elastic modulus) and 'one-point' pulse wave velocity each showed inverse correlation with E-wave velocity, E' velocity and E/A ratio, and direct correlation with A-wave velocity, E-wave deceleration time and E/E' ratio (P < 0.05). Arterial compliance showed negative correlations with the echocardiographic indices of left ventricular diastolic function (P < 0.05). On logistic regression analysis, age, hypertension, SBP, pulse pressure, left ventricular mass index, carotid IMT and stiffness parameters were associated with grade I left ventricular diastolic dysfunction (P < 0.05 for each). However, on multivariate logistic analysis, only 'one-point' pulse wave velocity and age were independent predictors (P = 0.038 and P = 0.016, respectively). CONCLUSION: An independent association between grade I left ventricular diastolic dysfunction and increased arterial stiffness is demonstrated at the earliest stage of heart failure. Hence, assessment of vascular function, beyond cardiac function, should be included in a comprehensive clinical evaluation of these patients.
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Zito et al. (2014) conducted a cross-sectional in Increased risk of heart failure without structural heart disease (Stage A) (n=127). Arterial stiffness was evaluated on Grade I left ventricular diastolic dysfunction (p=0.038). Increased arterial stiffness, measured by 'one-point' pulse wave velocity, was an independent predictor of grade I left ventricular diastolic dysfunction (P=0.038).
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