Longitudinal Changes in LV Structure and Diastolic Function in Relation to Arterial Properties in General Population.
We assessed to what extent arterial properties measured at baseline and follow-up predict longitudinal alterations in echocardiographic indexes reflecting left ventricular (LV) structure and function.



Serial imaging studies are needed to clarify the relation of changes in LV structure and function to arterial stiffness.



In 607 participants (50.7% women; mean age 50.7 years), using echocardiography and Doppler imaging, we measured LV dimensions, transmitral blood flow, and mitral annular tissue velocities at baseline and after 4.7 years. Using applanation tonometry, we assessed central pulse pressure (cPP) and carotid-femoral pulse wave velocity (PWV) at baseline. We regressed longitudinal changes in LV indexes on the arterial stiffness parameters and reported standardized effect sizes as a fraction of SD of LV change.



After full adjustment, longitudinal increase in LV septal (standardized effect size: +14.4%; p = 0.0018) and posterior wall (+12.6%; p = 0.0027) thickness was associated with higher baseline PWV, whereas LV internal diameter (-12.4%; p = 0.012) decreased during follow-up with PWV. Consequently, greater increase in relative wall thickness was associated with higher baseline PWV (+17.2%; p <0.0001). Participants with higher baseline PWV had a greater risk to develop or retain LV concentric remodeling during follow-up (odds ratio 1.35; p = 0.028). In addition, in women, baseline cPP predicted a greater increase in LV mass (+22.8%; p = 0.0009) and E/e' ratio (+36.1%; p <0.0001).



Progression to LV concentric remodeling pattern was associated with higher baseline PWV. In women, cPP predicted worsening of LV diastolic function. Our study highlights the importance of arterial properties as mediator of LV concentric remodeling in men and women, and diastolic dysfunction in women.
Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Nicholas
N
Cauwenberghs
Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Hypertension Division, Department of Internal Medicine, University Clinical Centre Ljubljana, Ljubljana, Slovenia.
Judita
J
Knez
Division of Cardiovascular Imaging and Dynamics, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Jan
J
D'hooge
Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Lutgarde
L
Thijs
Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Wen-Yi
WY
Yang
Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Fang-Fei
FF
Wei
Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Zhen-Yu
ZY
Zhang
Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Jan A
JA
Staessen
Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium. Electronic address: tatiana.kouznetsova@med.kuleuven.be.
Tatiana
T
Kuznetsova
D000328:Adult; D000368:Aged; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D063177:Pulse Wave Analysis; D012307:Risk Factors; D013997:Time Factors; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
arterial stiffness; diastolic function; general population; left ventricular structure