title: Early contribution of arterial wave reflection to left ventricular relaxation abnormalities in a community-dwelling population of normotensive and untreated hypertensive men and women.
abstract: We examined the contribution of arterial wave reflection to early abnormalities in left ventricular relaxation, whether this association was modified by gender or hypertension and the role of reflected wave timing and amplitude. We studied a cohort of normotensive and untreated essential hypertensive Taiwanese participants (675 men, 601 women, mean age 52 years). Doppler flow and applanation tonometry were performed to assess carotid-femoral pulse wave velocity (PWV) and augmentation index (AI). Diastolic parameters including the ratio between the peak velocity of early and late diastolic mitral inflow (E/A), E-deceleration time and left atrial (LA) diameter were measured by echocardiography. In multivariate models predicting E/A, women were more likely to have lower E/A than men (β=-0.08, P<0.001). AI was significantly associated with lower E/A in both men (β=-0.09, P=0.005) and women (β=-0.12, P<0.001) independent of PWV. Inclusion of AI in the overall model reduced the gender difference in E/A by 61% and rendered it nonsignificant. There was a significant interaction between AI and hypertension (P=0.02). The inverse association between AI and E/A was significant only in normotensive men and women, and only for the amplitude but not timing of the reflected wave. In conclusion, the contribution of wave reflection to left ventricular diastolic dysfunction was independent of arterial stiffness, more pronounced in normotensive individuals and explained a significant portion of the gender difference in diastolic function.
authors.affiliation: 1] Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute on Aging, NIH, Baltimore, MD, USA [2] Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD, USA [3] Division of Cardiology, Research Center of Cardiovascular Biology, University of Genova, Genova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Canepa
authors.affiliation: 1] Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute on Aging, NIH, Baltimore, MD, USA [2] Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: M
authors.initials: M
authors.lastname: Alghatrif
authors.affiliation: 1] Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute on Aging, NIH, Baltimore, MD, USA [2] Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Strait
authors.affiliation: 1] Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan [2] Department of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: H-M
authors.initials: HM
authors.lastname: Cheng
authors.affiliation: Division of Preventive Medicine and Health Service, Research Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: S-Y
authors.initials: SY
authors.lastname: Chuang
authors.affiliation: 1] Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan [2] Department of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Research Center of Cardiovascular Biology, University of Genova, Genova, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Brunelli
authors.affiliation: Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD, USA.
authors.forename: L
authors.initials: L
authors.lastname: Ferrucci
authors.affiliation: Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute on Aging, NIH, Baltimore, MD, USA.
authors.forename: E G
authors.initials: EG
authors.lastname: Lakatta
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003971:Diastole; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012737:Sex Factors; D013318:Stroke Volume; D013624:Taiwan; D013997:Time Factors; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left
references.citation: J Am Coll Cardiol. 2012 Nov 20;60(21):2170-7
references.pmid: 23103044
references.citation: Heart Fail Rev. 2000 Dec;5(4):345-55
references.pmid: 11498648
references.citation: Am J Hypertens. 2002 May;15(5):453-8
references.pmid: 12022248
references.citation: J Am Coll Cardiol. 2008 Apr 8;51(14):1377-83
references.pmid: 18387440
references.citation: Evid Based Ment Health. 2009 Aug;12(3):68-71
references.pmid: 19633239
references.citation: Hypertension. 2002 Mar 1;39(3):744-9
references.pmid: 11897756
references.citation: JAMA. 2011 Aug 24;306(8):856-63
references.pmid: 21862747
references.citation: Curr Opin Cardiol. 2011 Nov;26(6):562-8
references.pmid: 21993357
references.citation: J Am Coll Cardiol. 2002 Jun 19;39(12):2005-11
references.pmid: 12084601
references.citation: Hypertension. 2012 Aug;60(2):362-8
references.pmid: 22753223
references.citation: Hypertension. 2010 Mar;55(3):799-805
references.pmid: 20065155
references.citation: Circulation. 1989 Dec;80(6):1652-9
references.pmid: 2598428
references.citation: J Am Coll Cardiol. 2011 Mar 8;57(10):1226-33
references.pmid: 21371640
references.citation: Am J Physiol Heart Circ Physiol. 2001 Apr;280(4):H1846-52
references.pmid: 11247800
references.citation: Hypertension. 2004 Jun;43(6):1239-45
references.pmid: 15123572
references.citation: Circulation. 1996 Jun 1;93(11):2080-7
references.pmid: 8640985
references.citation: Circulation. 1989 Jun;79(6):1226-36
references.pmid: 2498005
references.citation: Circulation. 2002 Apr 23;105(16):1928-33
references.pmid: 11997279
references.citation: J Am Coll Cardiol. 2005 Nov 1;46(9):1753-60
references.pmid: 16256881
references.citation: J Am Coll Cardiol. 2007 Oct 16;50(16):1570-7
references.pmid: 17936156
references.citation: J Hypertens. 2010 Feb;28(2):306-13
references.pmid: 20051902
references.citation: J Am Coll Cardiol. 2001 Mar 15;37(4):1042-8
references.pmid: 11263606
references.citation: J Am Soc Echocardiogr. 2009 Feb;22(2):107-33
references.pmid: 19187853
references.citation: Am J Hypertens. 2008 Nov;21(11):1194-202
references.pmid: 18787521
references.citation: Circ Heart Fail. 2009 Mar;2(2):105-12
references.pmid: 19808325
references.citation: Circulation. 1998 Aug 4;98(5):422-8
references.pmid: 9714092
references.citation: JAMA. 2012 Sep 5;308(9):875-81
references.pmid: 22948697
references.citation: JAMA. 2006 Nov 8;296(18):2209-16
references.pmid: 17090767
references.citation: J Hum Hypertens. 2008 Oct;22(10):687-98
references.pmid: 18480831
references.citation: Hypertension. 2009 Dec;54(6):1328-36
references.pmid: 19884567
references.citation: J Am Coll Cardiol. 2013 Jan 8;61(1):96-103
references.pmid: 23122799
references.citation: J Am Coll Cardiol. 2011 Mar 8;57(10):1234-6
references.pmid: 21371641
references.citation: J Hypertens. 2009 Mar;27(3):461-7
references.pmid: 19330899
references.citation: Am J Cardiol. 2006 Nov 15;98(10):1387-92
references.pmid: 17134635
references.citation: Am J Physiol. 1991 Sep;261(3 Pt 2):H805-13
references.pmid: 1887926
references.citation: Eur Heart J. 2006 Nov;27(21):2588-605
references.pmid: 17000623