The relationship between ambulatory arterial stiffness index and left ventricular diastolic dysfunction in HFpEF: a prospective observational study

BACKGROUND: The relationship between ambulatory arterial stiffness index (AASI) and left ventricular diastolic dysfunction (LVDD) in patients with heart failure with preserved ejection fraction (HFpEF) is unknown. We aimed to investigate the association between the AASI and LVDD in HFpEF. METHODS: We prospective enrolled consecutive patients with HFpEF in Chongqing, China. Twenty-four-hour ambulatory blood pressure monitoring (24 h-ABPM) and echocardiography were performed in each patient. AASI was obtained through individual 24 h-ABPM. The relationship between AASI and LVDD was analyzed. RESULTS: A total of 107 patients with HFpEF were included. The mean age was 68.45 ± 14.02 years and 63 (59%) were women. The patients were divided into two groups according to the upper normal border of AASI (0.55). AASI > 0.55 group were more likely to be older, to have higher mean systolic blood pressure and worsen left ventricular diastolic function than AASI group ≤ 0.55. AASI was closely positive related to the diastolic function parameters, including mean E/e' (r = 0.307, P = 0.001), septal E/e' (r = 0.290, P = 0.002), lateral E/e' (r = 0.276, P = 0.004) and E (r = 0.274, P = 0.004). After adjusting for conventional risk factors, AASI was still an independent risk factors of mean E/e' > 10 in patients with HFpEF (OR: 2.929, 95%CI: 1.214-7.064, P = 0.017), and the association between AASI and mean E/e' > 14 was reduced (OR: 2.457, 95%CI: 1.030-5.860, P = 0.043). AASI had a partial predictive value for mean E/e' > 10 (AUC = 0.691, P = 0.002), while the predictive value for mean E/e' > 14 was attenuated (AUC = 0.624, P = 0.034). CONCLUSION: AASI was positive related to E/e' in HFpEF and might be an independent risk factor for the increase of mean E/e'.