title: Aortic calcification is associated with arterial stiffening, left ventricular hypertrophy, and diastolic dysfunction in elderly male patients with hypertension.
abstract: BACKGROUND
  Stiffening of large arteries can result in changes of cardiac structure and function by increasing afterload to the left ventricle. Calcification has been proposed as a mechanism underlying progression of arterial stiffening. The aim of the current study was to investigate the relationship between aortic calcification, arterial stiffening, left ventricular hypertrophy, and diastolic dysfunction.
  
  
  METHODS
  One hundred and sixty-four hypertensive elderly (≥65 years old) male patients with normal left ventricular systolic function (left ventricular ejection fraction ≥55%) underwent transthoracic echocardiography, brachial-ankle pulse wave velocity (baPWV), and noncontrast computed tomography. Coronary artery calcium score and aorta calcium score (ACS) were measured on noncontrast computed tomography using the volume method. Left ventricular dimensions, mitral inflow velocities, and early mitral annular (E') velocity were measured using transthoracic echocardiography. The left ventricular mass index (LVMI) was calculated.
  
  
  RESULTS
  The logACS was associated with mean baPWV (r = 0.387, P = 0.001), LVMI (r = 0.241, P < 0.002), E' velocity (r = -0.293, P < 0.001), and E/E' (r = 0.194, P = 0.013), suggesting arterial stiffening, increased left ventricular mass, and diastolic dysfunction in patients with raised ACS. On multivariate analysis, the LVMI showed an independent positive association with the logACS, even after adjusting for various clinical variables and the coronary artery calcium score (P = 0.009). Similarly, E' velocity also demonstrated an independent negative association with the logACS on multivariate analysis (P = 0.003). The mean baPWV, LVMI, and E' velocity showed similar correlations with both thoracic and abdominal ACS, even when thoracic and abdominal calcium scores were calculated separately.
  
  
  CONCLUSIONS
  Heavy aortic calcification and resultant arterial stiffening might underlie left ventricular hypertrophy and diastolic dysfunction in elderly male patients with hypertension.
authors.affiliation: aDivision of Cardiology, Department of Internal Medicine bSeverance Biomedical Science Institute, Yonsei University College of Medicine, Seoul cDivision of Cardiology, Department of Internal Medicine, College of Medicine, Kwandong University, Gangneung dDivision of Cardiology, National Health Insurance Corporation Ilsan Hospital, Goyang, Republic of Korea.
authors.forename: In-Jeong
authors.initials: IJ
authors.lastname: Cho
authors.forename: Hyuk-Jae
authors.initials: HJ
authors.lastname: Chang
authors.forename: Hyung-Bok
authors.initials: HB
authors.lastname: Park
authors.forename: Ran
authors.initials: R
authors.lastname: Heo
authors.forename: Sanghoon
authors.initials: S
authors.lastname: Shin
authors.forename: Chi Young
authors.initials: CY
authors.lastname: Shim
authors.forename: Geu-Ru
authors.initials: GR
authors.lastname: Hong
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001027:Aortography; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D003971:Diastole; D004452:Echocardiography; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D063177:Pulse Wave Analysis; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology*