title: Doppler indexes of left ventricular systolic and diastolic function in relation to the arterial stiffness in a general population.
abstract: BACKGROUND
  Late-systolic loading of the left ventricular (LV) is determined by arterial wave reflections and central vascular stiffening. We, therefore, investigated the relationship between various Doppler indexes reflecting LV systolic and diastolic function and arterial stiffness in the framework of a large population study of randomly recruited study participants.
  
  
  METHODS
  In 1233 study participants (51.7% women; mean age, 48 years; 41.5% hypertensive), using conventional and tissue Doppler imaging, we measured: the transmitral early (E) and late (A) diastolic velocities; tissue Doppler imaging systolic and early (e') and late diastolic mitral annular velocities; and end-systolic longitudinal and radial strain. Using applanation tonometry, we assessed central pulse pressure (cPP), augmentation pressure and carotid-femoral pulse wave velocity.
  
  
  RESULTS
  After full adjustment, transmitral E and A peaks increased with augmentation pressure and cPP (P less than 0.0001) and e' was positively associated with cPP (P = 0.013). The E/e' ratio increased significantly with augmentation pressure (P less than 0.0001), cPP (P less than 0.0001) and pulse wave velocity (P = 0.048). Although accounting for covariables, all arterial indexes were on average significantly higher in the diastolic dysfunction group with elevated filling pressure (n = 171) when compared to participants with normal diastolic function (n = 961; P ≤ 0.0004) or with impaired relaxation (n = 101; P ≤ 0.008). Longitudinal strain decreased independently with mean arterial pressure (P = 0.03). The correlation between radial strain and the arterial indexes shifted from positive at middle age (50-60 years) to negative at older (P less than 0.0001 for interaction).
  
  
  CONCLUSIONS
  Our study underscored the importance of arterial characteristics as a mediator of LV systolic and diastolic dysfunction. We demonstrated an age-dependent relationship between radial strain and indexes of arterial stiffness.
authors.affiliation: aDepartment of Cardiovascular Sciences, The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, University of Leuven, Leuven, Belgium bThe Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy cDepartment of Cardiovascular Sciences, Division of Cardiovascular Imaging and Dynamics, University of Leuven, Leuven, Belgium dThe First Department of Cardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland eStanford Cardiovascular Institute, Stanford, California, USA fDepartment of Hypertension and Diabetology, Hypertension Unit, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Cauwenberghs
authors.forename: Judita
authors.initials: J
authors.lastname: Knez
authors.forename: Valérie
authors.initials: V
authors.lastname: Tikhonoff
authors.forename: Jan
authors.initials: J
authors.lastname: D'hooge
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Kloch-Badelek
authors.forename: Lutgarde
authors.initials: L
authors.lastname: Thijs
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Stolarz-Skrzypek
authors.forename: Francois
authors.initials: F
authors.lastname: Haddad
authors.forename: Wiktoria
authors.initials: W
authors.lastname: Wojciechowska
authors.forename: Ewa
authors.initials: E
authors.lastname: Swierblewska
authors.forename: Edoardo
authors.initials: E
authors.lastname: Casiglia
authors.forename: Kalina
authors.initials: K
authors.lastname: Kawecka-Jaszcz
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Narkiewicz
authors.forename: Jan A
authors.initials: JA
authors.lastname: Staessen
authors.forename: Tatiana
authors.initials: T
authors.lastname: Kuznetsova
mesh_terms: D003430:Cross-Sectional Studies; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013599:Systole / Q000502:physiology*; D059289:Vascular Stiffness / Q000502:physiology*