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Subclinical association of aortic stiffness with cardiac structure and function in African-Americans: The Jackson

Mawra Jha1, Solomon Musani2,3, Inbar McCarthy4

  • 1Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RW-453, Boston, MA, 02215, USA.

The International Journal of Cardiovascular Imaging
|June 22, 2024
PubMed

Insights

Aortic stiffness is linked to early signs of adverse left ventricular (LV) function in Black adults without cardiovascular disease (CVD). This association appears localized to the base of the LV, suggesting specific patterns of subclinical cardiac changes.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Public Health

Background:

  • Cardiovascular disease (CVD) poses a significant health burden, particularly for Black adults, with high rates of morbidity and mortality.
  • Limited data exist on the subclinical relationship between aortic stiffness and left ventricular (LV) function and remodeling specifically within the Black population.

Purpose of the Study:

  • To investigate the detailed subclinical associations between aortic stiffness and LV structure and function in Black adults without prevalent CVD.
  • To explore regional differences in these associations within the left ventricle.

Main Methods:

  • Utilized cardiovascular magnetic resonance (CMR) imaging in 1050 U.S. Black adults from the Jackson Heart Study without CVD.
  • Assessed regional and global aortic stiffness using pulse wave velocity (PWV) measurements (aortic arch [AA-PWV] and thoracic aorta [T-PWV]).
  • Evaluated LV structure and function, including LV mass indexed to body surface area (LVMI), end-diastolic volume (LVEDV), ejection fraction (EF), and global and regional circumferential strain (Ecc).

Main Results:

  • Higher aortic stiffness (both AA-PWV and T-PWV) was associated with increased LV mass indexed to body surface area (LVMI).
  • Increased aortic stiffness (AA-PWV and T-PWV) correlated with worse (more positive) circumferential strain (Ecc) at the base of the left ventricle, but not at the mid-LV or apex.
  • No significant associations were found between aortic stiffness parameters and LV mass/LVEDV or ejection fraction (EF).

Conclusions:

  • In Black adults without CVD, aortic stiffness is associated with subclinical adverse LV function, specifically impacting the basal segments.
  • These findings highlight a potential localized pattern of subclinical cardiac changes related to aortic stiffness in this demographic.
  • Further research is warranted to understand the temporal relationship between aortic stiffness and the progression of LV remodeling, dysfunction, and associated prognosis in Black individuals.

Keywords:
Aortic stiffnessCardiovascular magnetic resonanceLeft ventriclePulse wave velocityStrain

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