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Left ventricular diastolic dysfunction is accompanied by increased aortic stiffness in the early stages of essential

Costas Tsioufis1, Dimitris Chatzis, Kyriakos Dimitriadis

  • 1Department of Cardiology, Hippokratio Hospital, 43 Agias Marinas Street, Melissia 15127, Athens, Greece. ktsioufis@hippocratio.gr

Journal of Hypertension
|August 12, 2005
PubMed

Insights

Newly diagnosed hypertension shows increased aortic stiffness and impaired left ventricular diastolic function. These findings suggest a shared pathway linking aortic stiffness and diastolic dysfunction in essential hypertension.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Physiology

Background:

  • Essential hypertension is a major risk factor for cardiovascular disease.
  • Aortic stiffness and left ventricular (LV) diastolic dysfunction are independent predictors of cardiovascular events.
  • The relationship between aortic stiffness and LV diastolic function in newly diagnosed, uncomplicated essential hypertension requires further elucidation.

Purpose of the Study:

  • To investigate the inter-relationship between aortic stiffness and LV diastolic function.
  • To assess whether increased aortic stiffness is associated with impaired LV diastolic function in subjects with newly diagnosed essential hypertension.

Main Methods:

  • 106 subjects with newly diagnosed essential hypertension and 50 normotensive controls were studied.
  • LV diastolic function was assessed using pulsed tissue Doppler imaging (TDI) echocardiography, measuring mitral annular velocities (Emav, Amav, Emav/Amav ratio).
  • Aortic stiffness was evaluated non-invasively using carotid-femoral pulse wave velocity (c-f PWV) measurement.

Main Results:

  • Hypertensive subjects exhibited significantly greater LV mass index, Amav, and c-f PWV compared to normotensives.
  • Hypertensives also showed lower Emav and Emav/Amav ratios, indicating impaired LV diastolic function.
  • In hypertensive subjects, c-f PWV was negatively associated with Emav and Emav/Amav ratio (P < 0.005).
  • Multivariate analysis revealed that the TDI-derived Emav/Amav ratio was significantly associated with age, relative wall thickness, and c-f PWV (P < 0.03).

Conclusions:

  • Newly diagnosed essential hypertension is characterized by both increased aortic stiffness and impaired LV diastolic function.
  • These findings suggest a common pathophysiological pathway linking aortic stiffness and LV diastolic dysfunction in essential hypertension.
  • TDI-derived parameters are valuable in assessing LV diastolic function in hypertensive patients and their relationship with aortic stiffness.
Abstract

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