title: Vascular inflammation and aortic stiffness relate to early left ventricular diastolic dysfunction in prehypertension.
abstract: Prehypertension is characterized by an increased cardiovascular risk and by an increased prevalence of target organ damage compared with the pure normotensive state. The present study was designed to assess in prehypertensive subjects the possible relationships between early left ventricular dysfunction, vascular inflammation and aortic stiffness. The study population consisted of 31 untreated prehypertensive subjects (age: 34 ± 6 years, mean ± SD) and 31 age-matched pure normotensive controls. Left ventricular function was assessed by echocardiography, aortic distensibility parameters were derived from aortic diameters measured by ultrasonography, and high-sensitivity C-reactive protein was assessed by latex-enhanced reagent. Prehypertensive subjects displayed a significantly lower E/A ratio and a significantly greater deceleration time and isovolumetric relaxation time compared with normotensive controls. They also displayed aortic systolic diameter, diastolic diameter and mean aortic stiffness index beta significantly increased while systo-diastolic diameter change, mean aortic distensibility and aortic strain were significantly reduced compared with controls. Values of inflammatory markers were increased. At multiple regression analysis, E/A ratio was significantly related to high-sensitivity C-reactive protein and aortic stiffness index beta, after correction for age, left ventricular mass index and mean blood pressure (β coefficient = -0.49, overall r(2) = 0.24, p = 0.01 and β coefficient =-0.46, overall r(2) = 0.21, p = 0.02, respectively). Thus, in prehypertension, left ventricular dysfunction is significantly related to vascular inflammation and aortic stiffness, suggesting that early cardiac and vascular alterations may have an increased inflammatory process as a common pathophysiological link.
authors.affiliation: School of Medicine, Department of Cardiology, Gulhane Military Medical Academy, Etlik-Ankara, Turkey.
authors.forename: Turgay
authors.initials: T
authors.lastname: Celik
authors.forename: U Cagdas
authors.initials: UC
authors.lastname: Yuksel
authors.forename: Francesco
authors.initials: F
authors.lastname: Fici
authors.forename: Murat
authors.initials: M
authors.lastname: Celik
authors.forename: Halil
authors.initials: H
authors.lastname: Yaman
authors.forename: Selim
authors.initials: S
authors.lastname: Kilic
authors.forename: Atila
authors.initials: A
authors.lastname: Iyisoy
authors.forename: Raffaella
authors.initials: R
authors.lastname: Dell'oro
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yokusoglu
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D003971:Diastole; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation; D008297:Male; D058246:Prehypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012307:Risk Factors; D013318:Stroke Volume; D013599:Systole; D014463:Ultrasonography; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*
chemical_list: D002097:C-Reactive Protein