title: Aortic stiffness is an independent determinant of left ventricular diastolic dysfunction in metabolic syndrome patients.
abstract: BACKGROUND
  We aimed to evaluate the relationship between arterial stiffness and left ventricular diastolic dysfunction (LVDD) in metabolic syndrome (MetS) patients.
  
  
  METHODS
  A cross-sectional study was conducted in 1208 subjects without overt atherosclerotic disease. According to the cardiac ultrasound, patients were divided into two groups: with LVDD (LVDD+, n = 1119) and without LVDD (LVDD-, n = 89). Arterial stiffness parameters [carotid-femoral pulse wave velocity (cfPWV) and aortic augmentation index (AIxHR75)] were assessed by applanation tonometry.
  
  
  RESULTS
  In comparison to LVDD-, LVDD + patients were older (55 ± 6 vs 51 ± 6 years, p < 0.001), and had higher cfPWV (8.8 ± 1.6 vs 7.9 ± 1.34 m/s, p < 0.001), AIxHR75 (24.7 ± 10.2 vs 19.7 ± 10, p < 0.001), mean arterial pressure (108 ± 12 vs 101 ± 10 mmHg, p < 0.001), heart rate (66 ± 10 vs 61 ± 9 bpm, p < 0.001), left ventricular mass index (LVMI) (109 ± 24 vs 97 ± 22, p < 0.001) and body mass index (BMI) (32 ± 5 vs 30 ± 4 kg/m(2), p < 0.001). We found significant correlations between cfPWV, AIxHR75 and the ratio of early to late transmitral velocities (E/A) (rcfPWV = -0.19, rAIxHR75 = -0.15, p < 0.001), early diastolic mitral annular velocity (E') (rcfPWV = -0.25, rAIxHR75 = -0.18, p < 0.05) and E/E' ratio (rcfPWV = 0.17, rAIxHR75 = 0.14, p < 0.001). Univariate analysis revealed that the presence of LVDD is associated with age [odds ratio (OR) 1.84], BMI (OR 1.63), waist circumference (WC) (OR 1.52), cfPWV (OR 2.18), AIxHR75 (OR 1.55), mean aortic blood pressure (OR 1.94), aortic pulse pressure (OR 1.78), mean common carotid artery intima-media thickness (OR 1.16), heart rate (OR 1.4) and LVMI (OR 1.79) (all p < 0.05). After performing stepwise multiple logistic regression analysis, only cfPWV and BMI or WC remained significant predictors of the presence of LVDD (p < 0.05).
  
  
  CONCLUSIONS
  cfPWV is a significant determinant of LVDD in subjects with MetS.
authors.affiliation: a Vilnius University Hospital Santariškių Klinikos , Vilnius Lithuania.|b Faculty of Medicine , Vilnius University , Vilnius , Lithuania.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Solovjova
authors.affiliation: a Vilnius University Hospital Santariškių Klinikos , Vilnius Lithuania.|b Faculty of Medicine , Vilnius University , Vilnius , Lithuania.
authors.forename: Ligita
authors.initials: L
authors.lastname: Ryliškytė
authors.affiliation: a Vilnius University Hospital Santariškių Klinikos , Vilnius Lithuania.|b Faculty of Medicine , Vilnius University , Vilnius , Lithuania.
authors.forename: Jelena
authors.initials: J
authors.lastname: Čelutkienė
authors.affiliation: a Vilnius University Hospital Santariškių Klinikos , Vilnius Lithuania.|b Faculty of Medicine , Vilnius University , Vilnius , Lithuania.
authors.forename: Jolita
authors.initials: J
authors.lastname: Badarienė
authors.affiliation: a Vilnius University Hospital Santariškių Klinikos , Vilnius Lithuania.|b Faculty of Medicine , Vilnius University , Vilnius , Lithuania.
authors.forename: Rokas
authors.initials: R
authors.lastname: Navickas
authors.affiliation: a Vilnius University Hospital Santariškių Klinikos , Vilnius Lithuania.
authors.forename: Roma
authors.initials: R
authors.lastname: Puronaitė
authors.affiliation: b Faculty of Medicine , Vilnius University , Vilnius , Lithuania.
authors.forename: Grytė
authors.initials: G
authors.lastname: Bieliauskaitė
authors.affiliation: b Faculty of Medicine , Vilnius University , Vilnius , Lithuania.
authors.forename: Eglė
authors.initials: E
authors.lastname: Skiauterytė
authors.affiliation: b Faculty of Medicine , Vilnius University , Vilnius , Lithuania.
authors.forename: Giedrė
authors.initials: G
authors.lastname: Lisaitė
authors.affiliation: a Vilnius University Hospital Santariškių Klinikos , Vilnius Lithuania.|b Faculty of Medicine , Vilnius University , Vilnius , Lithuania.
authors.forename: Aleksandras
authors.initials: A
authors.lastname: Laucevičius
mesh_terms: D000367:Age Factors; D001794:Blood Pressure; D015992:Body Mass Index; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D003971:Diastole; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D016017:Odds Ratio; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D055105:Waist Circumference
keywords: Arterial stiffness; carotid–femoral pulse wave velocity (cfPWV); left ventricular diastolic dysfunction; metabolic syndrome