title: Age-specific relationship of aortic pulse wave velocity with left ventricular geometry and function in hypertension.
abstract: Aortic pulse wave velocity (PWV), generally considered an intrinsic marker of arterial stiffness, might depend in part on the velocity of myocardial fiber shortening, but the relation between PWV and myocardial function in humans has been understudied. A total of 237 untreated hypertensive subjects over a wide age range (18 to 88 years) underwent aortic PWV determination and echocardiography, from which the mean velocity of circumferential fiber shortening was calculated as a measure of the velocity of myocardial shortening, and relative wall thickness was taken as a measure of left ventricular concentric remodeling. Patients were divided in 3 age groups (<40 years, 40 to 59 years, and >or=60 years). In the young, aortic PWV was directly associated with heart rate-corrected velocity of circumferential fiber shortening (r=0.39; P=0.002) but not to relative wall thickness (r=-0.01; P=0.95). The opposite was found in the older group, in which aortic PWV was accompanied by a concentric left ventricular geometric pattern (r=0.44 with relative wall thickness; P=0.009) and a reduced velocity of circumferential fiber shortening (r=-0.54; P<0.001) and stress-corrected midwall fractional shortening (r=-0.56; P<0.001). Intermediate values were found in the middle-aged group (r=0.23; P<0.01 with relative wall thickness; r=-0.07, P value not significant with velocity of circumferential fiber shortening). In conclusion, the relation between aortic PVW and the left ventricle is strongly age dependent. These data suggest that, in young people, aortic PWV is partly determined by an increased velocity of myocardial shortening. With increasing age, a relationship between aortic PWV (as a measure of arterial stiffness) and left ventricular concentric geometry emerges, which ultimately leads to a depressed ventricular systolic function.
authors.affiliation: Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia Medical School, Hospital Santa Maria della Misericordia, Piazzale Menghini, 1, IT-06129 Perugia, Italy. skill@unipg.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Schillaci
authors.forename: Massimo R
authors.initials: MR
authors.lastname: Mannarino
authors.forename: Giacomo
authors.initials: G
authors.lastname: Pucci
authors.forename: Matteo
authors.initials: M
authors.lastname: Pirro
authors.forename: Johny
authors.initials: J
authors.lastname: Helou
authors.forename: Gianluca
authors.initials: G
authors.lastname: Savarese
authors.forename: Gaetano
authors.initials: G
authors.lastname: Vaudo
authors.forename: Elmo
authors.initials: E
authors.lastname: Mannarino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001011:Aorta / Q000503:physiopathology*; D001783:Blood Flow Velocity; D004452:Echocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011674:Pulse; D013599:Systole; D013997:Time Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling