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Updated: Feb 6, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Do treatment-induced changes in arterial stiffness affect left ventricular structure? A meta-analysis
Koen M van der Waaij1,2, Maarten H G Heusinkveld1, Tammo Delhaas1
1Department of Biomedical Engineering.
Insights
Reducing arterial stiffness, measured by pulse wave velocity (PWV), is linked to decreased left ventricular mass (LVM). This study reviewed interventions, finding a significant association between lower arterial stiffness and reduced LVM, suggesting a potential pathway for managing cardiac health.
Area of Science:
- Cardiovascular Research
- Vascular Physiology
- Clinical Intervention Studies
Background:
- Arterial stiffness, quantified by pulse wave velocity (PWV), is recognized as blood pressure dependent.
- A proposed pathophysiological pathway links increased arterial stiffness to elevated blood pressure, leading to left ventricular hypertrophy (LVH).
Purpose of the Study:
- To systematically review antihypertensive and lifestyle intervention studies.
- To determine the association between changes in arterial stiffness, blood pressure, and left ventricular mass (LVM).
Main Methods:
- A systematic literature search was conducted across PubMed, EMBASE, Cochrane, and Web of Science.
- Data from 23 studies involving 2573 patients were analyzed, reporting changes in PWV, SBP, DBP, and LVMI.
Main Results:
- Significant reductions in SBP, PWV, and LVMI were observed across numerous studies.
- A significant positive correlation (r=0.61, P=0.003) was found between arterial stiffness reduction and LVM reduction (6.9 g/m per 1.0 m/s decrease in PWV).
- SBP reduction did not significantly correlate with reductions in PWV or LVMI.
Conclusions:
- Decreased arterial stiffness is associated with a reduction in left ventricular mass.
- Further research with longitudinal designs and blood pressure-independent stiffness indices is needed to establish causality between arterial stiffness, blood pressure, and LVH.
Background:
Vascular research demonstrated that pulse wave velocity (PWV), a measure of arterial stiffness, is inherently blood pressure dependent. Considering the hypothesized pathophysiological chain of increased arterial stiffness leading to increased blood pressure load with consequent left ventricular hypertrophy (LVH) development, we conducted a systematic review of antihypertensive and lifestyle intervention studies to determine the association between, on the one hand, changes in arterial stiffness and blood pressure, and, on the other hand, changes in left ventricular mass (LVM).
Methods:
Using PubMed, EMBASE, Cochrane and Web of Science, we identified 23 studies, containing 2573 patients. Studies reported changes in arterial stiffness (assessed by means of PWV), SBP, DBP and LVM index (LVMI), respectively.
Results:
Statistically significant reductions in SBP, PWV and LVMI were reported in 16, 14 and 20 studies, respectively. Pooled analysis of studies showed that the proportion in SBP reduction did not correlate significantly to the proportion in reductions of the other two variables. On the contrary, we found a significant positive correlation (r = 0.61, P = 0.003) between arterial stiffness and reduction of LVM, expressed as a relevant reduction in LVMI of 6.9 g/m per 1.0 m/s reduction in PWV.
Conclusion:
Our findings provide evidence that a decrease in arterial stiffness is associated with reduction of LVM. To investigate whether there exists a causal relation between LVH due to arterial stiffness increases and in turn blood pressure load increases, future studies should strive for a multiple follow-up design and use of blood pressure independent or corrected stiffness indices.
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