Arterial stiffness and wave reflection: sex differences and relationship with left ventricular diastolic function
Cesare Russo1, Zhezhen Jin, Vittorio Palmieri
1Department of Medicine, Columbia University, New York, NY, USA.
Hypertension (Dallas, Tex. : 1979)
|July 4, 2012
Summary
Arterial stiffness, a measure of blood vessel elasticity, is linked to impaired heart function in both men and women. Women exhibit higher arterial stiffness, potentially increasing their risk for heart failure with normal ejection fraction (HFNEF).
Area of Science:
- Cardiology
- Vascular Biology
- Cardiovascular Physiology
Background:
- Heart failure with normal ejection fraction (HFNEF) and left ventricular (LV) diastolic dysfunction are increasingly recognized conditions.
- Arterial stiffness and wave reflection are implicated in HFNEF and LV diastolic dysfunction.
- Women have a higher prevalence of HFNEF, but sex differences in arterial stiffness effects on LV diastolic function are not well understood.
Purpose of the Study:
- To investigate sex differences in the association between arterial stiffness, wave reflection, and LV diastolic function in a community-based cohort.
- To determine if arterial stiffness independently predicts LV diastolic dysfunction in men and women.
Main Methods:
- Applanation tonometry was used to assess arterial stiffness and wave reflection parameters (e.g., central pulse pressure/stroke volume index, augmentation index) in 983 participants.
- Left ventricular (LV) diastolic function was evaluated using 2-dimensional echocardiography and tissue-Doppler imaging.
- Statistical analyses were performed to examine relationships between arterial stiffness, wave reflection, and LV diastolic function, adjusting for covariates.
Main Results:
- Women exhibited greater arterial stiffness and wave reflection than men, independent of body size and heart rate.
- Higher arterial stiffness and wave reflection were associated with poorer LV diastolic function in both sexes.
- A higher central pulse pressure/stroke volume index independently predicted LV diastolic dysfunction in both women and men after risk factor adjustment.
Conclusions:
- Increased arterial stiffness is associated with impaired LV diastolic function in both men and women.
- Women's inherently higher arterial stiffness may contribute to their increased susceptibility to developing HFNEF.
- These findings highlight the importance of assessing arterial stiffness in managing diastolic dysfunction and preventing HFNEF, particularly in women.
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