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The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals.

Abstract：

BACKGROUND:The current standard for arterial stiffness assessment, aortic pulse wave velocity (aPWV), is measured at diastolic pressure. Arterial stiffness, however, is pressure dependent. At the carotid artery level, the degree of this dependency can be quantified as the difference (ΔPWV) between systolic and diastolic (cPWVd) carotid pulse wave velocity. Biomechanically, a greater ΔPWV implies greater increases in left ventricular afterload with physical activity. Therefore, we hypothesized, that ΔPWV is more strongly associated with left ventricular mass index (LVMI) than aPWV and cPWVd. METHODS:In 1776 healthy individuals from the Asklepios cohort (age 35-55 years), ΔPWV was obtained from combined carotid artery ultrasound and tonometry recordings. Multiple linear regression analysis was performed to investigate the associations of ΔPWV, cPWVd and aPWV with LVMI, adjusting for age, sex, mean blood pressure (MBP), central pulse pressure, and other possible confounders. RESULTS:ΔPWV was 2.4 ± 1.2 m/s (mean ± SD), ranging from 0.8 m/s, indicating almost constant arterial stiffness over the cardiac cycle, to 4.4 m/s, reflecting substantial pressure dependency. ΔPWV was significantly associated with LVMI (β of 2.46 g/m per m/s, P < 0.001), even after full adjustment (β of 0.56 g/m per m/s, P = 0.03). cPWVd and aPWV had clear crude associations with LVMI (P < 0.001), but lost significance after adjustment (β of -0.48 and -0.33 g/m per m/s, with P = 0.11 and 0.2, respectively). CONCLUSION:The change in arterial stiffness over the cardiac cycle, rather than diastolic stiffness, is independently associated with LVMI in healthy middle-aged individuals. Therefore, the pressure dependency of arterial stiffness should be considered in cardiovascular risk assessment.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

Hermeling E,Vermeersch SJ,Rietzschel ER,de Buyzere ML,Gillebert TC,van de Laar RJ,Ferreira I,Hoeks AP,van Bortel LM,Reneman RS,Segers P,Reesink KD

doi

10.1097/HJH.0b013e32834e4b75

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

396-402

issue

eissn

0263-6352

issn

1473-5598

journal_volume

pub_type

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The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals.