Author + information
- Received July 22, 2016
- Revision received October 12, 2016
- Accepted October 20, 2016
- Published online November 6, 2017.
- Nicholas Cauwenberghs, MSca,
- Judita Knez, MDa,b,
- Jan D’hooge, PhDc,
- Lutgarde Thijs, MSca,
- Wen-Yi Yang, MDa,
- Fang-Fei Wei, MDa,
- Zhen-Yu Zhang, MDa,
- Jan A. Staessen, MD, PhDa and
- Tatiana Kuznetsova, MD, PhDa,∗ ()
- aResearch Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- bHypertension Division, Department of Internal Medicine, University Clinical Centre Ljubljana, Ljubljana, Slovenia
- cDivision of Cardiovascular Imaging and Dynamics, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- ↵∗Address for correspondence:
Dr. Tatiana Kuznetsova, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Campus Sint Rafaël, Kapucijnenvoer 35, Block D, box 7001, B-3000 Leuven, Belgium.
Objectives We assessed to what extent arterial properties measured at baseline and follow-up predict longitudinal alterations in echocardiographic indexes reflecting left ventricular (LV) structure and function.
Background Serial imaging studies are needed to clarify the relation of changes in LV structure and function to arterial stiffness.
Methods In 607 participants (50.7% women; mean age 50.7 years), using echocardiography and Doppler imaging, we measured LV dimensions, transmitral blood flow, and mitral annular tissue velocities at baseline and after 4.7 years. Using applanation tonometry, we assessed central pulse pressure (cPP) and carotid-femoral pulse wave velocity (PWV) at baseline. We regressed longitudinal changes in LV indexes on the arterial stiffness parameters and reported standardized effect sizes as a fraction of SD of LV change.
Results After full adjustment, longitudinal increase in LV septal (standardized effect size: +14.4%; p = 0.0018) and posterior wall (+12.6%; p = 0.0027) thickness was associated with higher baseline PWV, whereas LV internal diameter (-12.4%; p = 0.012) decreased during follow-up with PWV. Consequently, greater increase in relative wall thickness was associated with higher baseline PWV (+17.2%; p <0.0001). Participants with higher baseline PWV had a greater risk to develop or retain LV concentric remodeling during follow-up (odds ratio 1.35; p = 0.028). In addition, in women, baseline cPP predicted a greater increase in LV mass (+22.8%; p = 0.0009) and E/e′ ratio (+36.1%; p <0.0001).
Conclusions Progression to LV concentric remodeling pattern was associated with higher baseline PWV. In women, cPP predicted worsening of LV diastolic function. Our study highlights the importance of arterial properties as mediator of LV concentric remodeling in men and women, and diastolic dysfunction in women.
The European Union (grants HEALTH-2011-278249-EUMASCARA, and ERC Advanced Grant-2011-294713-EPLORE) supported the Studies Coordinating Centre (SCC, Leuven, Belgium). The SCC also received grants from the Fonds voor Wetenschappelijk Onderzoek Vlaanderen, Brussels, Belgium (grants G.0880.13, G. 0881.13, and 11Z0916N). Dr. D’hooge collaborates with GE and Phillips; and has received consultant fees from SuperSonic Imagine. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received July 22, 2016.
- Revision received October 12, 2016.
- Accepted October 20, 2016.
- 2017 American College of Cardiology Foundation