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Published on: October 19, 2016
Arterial stiffness is associated with regional ventricular systolic and diastolic dysfunction: the Multi-Ethnic Study
Verônica Rolim S Fernandes1, Joseph F Polak, Susan Cheng
1Division of Cardiology, Johns Hopkins University, Baltimore, MD 21287, USA. jlima@jhmi.edu
Insights
Arterial stiffness is linked to impaired systolic and diastolic heart function, even before symptoms appear. This highlights the importance of vascular compliance in maintaining overall cardiac health.
Area of Science:
- Cardiovascular Imaging
- Vascular Physiology
- Cardiac Mechanics
Background:
- Left ventricular (LV) dysfunction with preserved ejection fraction (EF) has unclear pathophysiology.
- Limited research exists on the relationship between arterial compliance and LV function in humans.
- No prior studies utilized cardiovascular magnetic resonance (CMR) imaging to explore this connection.
Purpose of the Study:
- To investigate the association between arterial compliance and regional myocardial function.
- To determine if arterial stiffness impacts systolic and diastolic strain rates.
- To explore this relationship in participants of the Multi-Ethnic Study of Atherosclerosis (MESA).
Main Methods:
- Arterial compliance measured via carotid ultrasound (distensibility coefficient [DC], Young's modulus [YM]).
- Regional myocardial function assessed using circumferential systolic (SR(S)) and diastolic (SR(E)) strain rates derived from tagged CMR.
- Statistical analyses adjusted for cardiovascular risk factors and LV mass.
Main Results:
- Significant associations found between arterial compliance and SR(S) across all myocardial regions.
- Arterial compliance correlated with SR(E) in the lateral and septal walls.
- A direct linear relationship between carotid artery DC and SR(S) persisted after multivariable adjustment.
Conclusions:
- Arterial stiffness is associated with early, asymptomatic impairment of both systolic and diastolic myocardial function.
- Vascular compliance plays a role in the development of ventricular dysfunction.
- Further research is required to fully understand the impact of vascular compliance on heart failure development.
Objective:
The pathophysiology of left ventricular (LV) dysfunction, particularly in the setting of a preserved ejection fraction (EF), remains unclear. Few studies have investigated the relationship between arterial compliance and LV function in humans, and none used cardiovascular MRI.
Methods And Results:
We sought to determine whether arterial compliance is related to regional myocardial function among participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Arterial compliance was assessed using carotid ultrasound measurements to calculate the distensibility coefficient (DC) and Young's modulus (YM). Circumferential systolic (SR(S)) and diastolic (SR(E)) strain rates were calculated by harmonic phase (HARP) from tagged MRI. Associations between arterial compliance and indices of ventricular function were adjusted for cardiovascular risk factors. We found a significant association between arterial compliance and SR(S) in all myocardial regions (P<0.05); arterial compliance was also associated with SR(E) in the lateral and septal wall regions (P<0.05). Multiple linear regression analyses demonstrated a direct linear relationship between the carotid artery DC and SR(S) across all LV segments and slices, even after adjustment for cardiovascular risk factors and LV mass. In regression analyses, a significant relationship between arterial compliance and SR(E) in the septal and antero-apical walls was also found and remained significant after multivariable adjustment.
Conclusions:
Arterial stiffness is associated with early and asymptomatic impairment of systolic as well as diastolic myocardial function. Further studies are needed to elucidate role of vascular compliance in the development of ventricular dysfunction and failure.
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