Low peripheral vasoreactivity was associated with higher odds of left ventricular hypertrophy (adjusted OR 2.60; p=0.0040) and diastolic dysfunction (adjusted OR 2.66; p=0.0037) compared to moderate-to-high vasoreactivity.
Cross-Sectional (n=424)
Is peripheral endothelial dysfunction associated with subclinical heart remodeling and dysfunction in the general population?
Decreased microvascular reactivity is associated with subclinical heart maladaptation, supporting the role of endothelial dysfunction in the pathogenesis of HFpEF.
Odds Ratio: 2.6
p-value: p=0.0040
AIMS: Epidemiological studies should substantiate the paradigm that endothelial dysfunction contributes to the development of heart failure with preserved ejection fraction (HFpEF). We investigated the association of cardiac remodeling and dysfunction with peripheral vasoreactivity in the general population. METHODS: In 424 individuals, we echocardiographically assessed cardiac structure and function and determined digital vasomotor function by photoplethysmography (PPG) during reactive hyperemia (RH). We regressed echocardiographic indexes and abnormalities on RH ratios averaged for 30 s time intervals. We derived sex-specific peripheral vasoreactivity profiles from PPG time-series and compared their echocardiographic phenotypes. RESULTS: Higher left ventricular (LV) mass index and lower E/A ratio and e' peak and left atrial reservoir strain were independently related to lower RH ratios. Participants with LV hypertrophy or diastolic dysfunction presented significantly lower RH ratios during the 30 to 240s intervals than normal counterparts. Low RH responders (n = 250) presented higher odds for LV hypertrophy (adjusted OR: 2.60; p = .0040) and LV diastolic dysfunction (adjusted OR: 2.66; p = .0037) than moderate-to-high responders (n = 174). CONCLUSION: The association between subclinical heart maladaptation and decreased microvascular reactivity supports the involvement of endothelial dysfunction in HFpEF pathogenesis. Time-integrated profiling of microvascular vasoreactivity may enable early detection of HFpEF in the community.
Cauwenberghs et al. (Mon,) conducted a cross-sectional in General population (n=424). Low reactive hyperemia (RH) response vs. Moderate-to-high RH responders was evaluated on Left ventricular hypertrophy (OR 2.60, p=0.0040). Low peripheral vasoreactivity was associated with higher odds of left ventricular hypertrophy (adjusted OR 2.60; p=0.0040) and diastolic dysfunction (adjusted OR 2.66; p=0.0037) compared to moderate-to-high vasoreactivity.
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