Left ventricular diastolic dysfunction is accompanied by increased aortic stiffness in the early stages of essential hypertension: a TDI approach.
OBJECTIVE
To investigate the inter-relationship between aortic stiffness and left ventricular (LV) diastolic function in subjects with newly diagnosed uncomplicated essential hypertension.


METHODS
We studied 106 consecutive newly diagnosed subjects (aged 51 years, 80 males) with stage I-II essential hypertension, and 50 normotensives matched for age, sex and body mass index. LV diastolic function was estimated by pulsed tissue Doppler imaging (TDI) echocardiography, averaging diastolic mitral annular velocity measurements (Emav, Amav, Emav/Amav ratio) from four separate sites (basal septal, lateral, anterior, and inferior LV wall). Moreover, aortic stiffness was evaluated by non-invasive carotid-femoral pulse wave velocity (c-f PWV) measurement.


RESULTS
Hypertensives compared with normotensives exhibited greater LV mass index and Amav (110 versus 95 g/m and 10 versus 8.8 cm/s, respectively, P < 0.001 for both cases), and greater c-f PWV (8.47 versus 7.48 m/s, P < 0.03), as well as lower Emav and Emav/Amav values, (8.4 versus 10 cm/s and 0.82 versus 1.15, respectively, P < 0.001 for both cases). In the group of hypertensives, a univariate analysis revealed that c-f PWV was negatively associated with Emav (r = -0.305, P = 0.005), as well as with Emav/Amav ratio (r = -0.437, P < 0.001). Moreover, a multivariate analysis showed that the TDI-derived Emav/Amav ratio was significantly associated with age (P = 0.001), relative wall thickness (P = 0.006) and c-f PWV (P = 0.03), while the conventional Doppler-derived E/A ratio was significantly associated only with age (P = 0.001).


CONCLUSIONS
TDI-detected LV diastolic dysfunction is accompanied by increased aortic stiffness in newly diagnosed essential hypertension, suggesting that there may be a common pathophysiological pathway linking these two entities.
Tsioufis
Costas
C
Department of Cardiology, Hippokratio Hospital, 43 Agias Marinas Street, Melissia 15127, Athens, Greece. ktsioufis@hippocratio.gr
Chatzis
Dimitris
D
Dimitriadis
Kyriakos
K
Stougianos
Pavlos
P
Kakavas
Apostolis
A
Vlasseros
Ioannis
I
Tousoulis
Dimitris
D
Stefanadis
Christodoulos
C
Kallikazaros
Ioannis
I
D000328:Adult; D001011:Aorta / Q000503:physiopathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D003187:Compliance; D003971:Diastole; D015150:Echocardiography, Doppler; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011674:Pulse; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*