PURPOSE: Diastolic dysfunction (DD) and increased arterial stiffness increase in prevalence with advancing age, share common risk factors, and are predictive of cardiovascular events. The relationship between arterial stiffness and DD has not been well studied. Accordingly, the aim of this study was to determine whether arterial wave reflection indices vary according to transmitral diastolic filling patterns.
METHODS: Seventy five patients (mean age 52±13years, 43% male) who underwent applanation tonometry within 24hrs of conventional echocardiography and tissue Doppler imaging were prospectively studied. All the patients had preserved ejection fraction (EF ≥ 50%). Patients were stratified into groups on the basis of left ventricular diastolic function as determined by echocardiogram (normal (NL), n = 24; delayed relaxation (DR), n = 24; pseudonormal (PN), n = 27). Pulse wave velocity (PWV), heart rate corrected augmentation index (AI75) and aortic blood pressure were obtained by applanation tonometry.
RESULTS: Hypertension and diabetes were more prevalent in the DD groups (PN and DR) than the NL group (p = <0.001 and p = 0.04 respectively). Other baseline characteristics were similar. AI75 was higher in the PN and DR groups than in the NL group (21.4 ± 14 vs. 18.2 ± 15 vs. 10.4 ± 13, p = 0.02). Aortic pulse pressure was higher in the PN and DR groups than in the NL group (48.3 ± 26 vs. 37.6 ± 16 vs. 33.7 ± 10, p = 0.01). There was no significant difference in PWV between PN, DR and NL groups (9.0 ± 1.6 vs. 7.9 ± 1.8 vs. 8.7 ± 2.1, p = 0.15). On multivariate analysis, AI75 and hypertension were independent predictors of DD (p = 0.04 and p = 0.001 respectively).
CONCLUSION: Indices of arterial wave reflection increase in a step-wise manner with progressive degrees of DD.
CLINICAL IMPLICATIONS: Arterial wave reflection is abnormal in patients with DD and may contribute to cardiovascular morbidity. Non-invasive arterial stiffness measurement may complement echocardiography in the assessment of diastolic function.
DISCLOSURE: Oladipupo Olafiranye, No Financial Disclosure Information; No Product/Research Disclosure Information