title: Relations of Central Hemodynamics and Aortic Stiffness with Left Ventricular Structure and Function: The Framingham Heart Study.
abstract: BACKGROUND
  The differing relations of steady and pulsatile components of central hemodynamics and aortic stiffness with cardiac dimensions and function have not been fully elucidated.
  
  
  RESULTS
  Central hemodynamics and carotid-femoral pulse wave velocity (CFPWV, a measure of aortic stiffness) were measured by arterial tonometry in 5799 participants of the Framingham Heart Study (mean age 51 years, 54% women) and related to echocardiographic left ventricular (LV) dimensions and systolic and diastolic function using multivariable-adjusted partial Pearson correlations. Mean arterial pressure (MAP, steady component of central blood pressure) was associated positively with LV wall thickness (r=0.168; P<0.0001) but showed only a weak direct association with LV diastolic dimension (r=0.035, P=0.006). Central pulse pressure (pulsatile component of central blood pressure) showed a direct correlation with both LV diastolic dimension and LV wall thickness (r=0.08 and 0.044, both P<0.0001 in multivariable models that included MAP). CFPWV was not associated with LV structure (all P≥0.27) in MAP-adjusted models). Both MAP and CFPWV were associated inversely with LV diastolic function (E'; r=-0.140 and -0.153, respectively; both P<0.0001), and these associations persisted after additional adjustment for LV mass and central pulse pressure (r=-0.142 and -0.108, both P<0.0001). MAP and CFPWV were not associated with LV fractional shortening (P≥0.10), whereas central pulse pressure was positively related (r=0.064, P<0.0001).
  
  
  CONCLUSIONS
  Pulsatile and steady components of central pressure are conjointly yet variably related to LV structure. CFPWV is related to LV diastolic function but not to systolic function. Additional studies are warranted to confirm these observations.
authors.affiliation: National Heart, Blood and Lung Institute's Framingham Heart Study, Framingham, MA Deutsches Herzzentrum, Munich, Germany garyfmitchell@mindspring.com bernhard_kaess@gmx.de.
authors.forename: Bernhard M
authors.initials: BM
authors.lastname: Kaess
authors.affiliation: National Heart, Blood and Lung Institute's Framingham Heart Study, Framingham, MA.
authors.forename: Jian
authors.initials: J
authors.lastname: Rong
authors.affiliation: National Heart, Blood and Lung Institute's Framingham Heart Study, Framingham, MA Department of Mathematics and Statistics, Boston University, Boston, MA Department of Biostatistics, Boston University School of Public Health, Boston, MA.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.affiliation: Evans Department of Medicine, Boston University School of Medicine, Boston, MA Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA.
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Hamburg
authors.affiliation: Evans Department of Medicine, Boston University School of Medicine, Boston, MA Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Vita
authors.affiliation: Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Susan
authors.initials: S
authors.lastname: Cheng
authors.affiliation: Veterans Administration Hospital, West Roxbury, MA Harvard Medical School, Boston, MA.
authors.forename: Jayashree
authors.initials: J
authors.lastname: Aragam
authors.affiliation: National Heart, Blood and Lung Institute's Framingham Heart Study, Framingham, MA Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
authors.affiliation: National Heart, Blood and Lung Institute's Framingham Heart Study, Framingham, MA Evans Department of Medicine, Boston University School of Medicine, Boston, MA Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA.
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.affiliation: National Heart, Blood and Lung Institute's Framingham Heart Study, Framingham, MA Evans Department of Medicine, Boston University School of Medicine, Boston, MA Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA.
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.affiliation: Cardiovascular Engineering, Inc, Norwood, MA garyfmitchell@mindspring.com bernhard_kaess@gmx.de.
authors.forename: Gary F
authors.initials: GF
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000368:Aged; D062186:Arterial Pressure; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D008365:Manometry; D008404:Massachusetts; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011673:Pulsatile Flow; D063177:Pulse Wave Analysis / Q000379:methods; D018570:Risk Assessment; D012307:Risk Factors; D013599:Systole; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology*; D016277:Ventricular Function, Left
keywords: aortic stiffness; diastolic dysfunction; left ventricle geometry; pulse wave velocity; systolic dysfunction