Arterial stiffness and left-ventricular diastolic dysfunction: Guangzhou Biobank Cohort Study-CVD

Brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, is an established cardiovascular risk factor of ventricular stiffening. We studied the association of baPWV with left-ventricular (LV) diastolic function in a sub-study of the Guangzhou Biobank Cohort Study. In all, 378 Chinese subjects with a normal ejection fraction (>50%) had baPWV measurement by a noninvasive automatic waveform analyser, carotid intima-medial thickness (IMT) measurement by B-mode ultrasonography and cardiac diastolic function assessment by echocardiography. After adjusting for age, both baPWV and IMT were associated with LV mass index, posterior wall end-diastolic thickness and inter-ventricular end-diastolic thickness, but only baPWV was associated with deceleration time, atrial flow velocity and E/A ratio. Multivariable linear regression model showed that baPWV and mean arterial pressure, but not IMT, were significantly associated with E/A ratio (β=-0.02, P=0.03 and β=-0.36, P=0.02, respectively). The receiver operator characteristic curve showed that baPWV was better than pulse pressure or mean arterial pressure to detect LV diastolic dysfunction (E/A<1.0). Our study suggested that increased baPWV might be an independent risk factor or marker for diastolic dysfunction. Early detection of an intervention on increased baPWV may be important for prevention of cardiac diastolic dysfunction.