Association Between Local Ascending Aortic Elastic Properties and Left Ventricular Global Longitudinal Strain in...

Background/Objectives: Multiple sclerosis (MS) has been associated with subclinical cardiovascular involvement, including impaired myocardial deformation and increased arterial stiffness. However, the local elastic properties of the ascending aorta and their relationship with subclinical left ventricular (LV) longitudinal dysfunction remain insufficiently characterized in MS. Methods: In this prospective cross-sectional study, 67 adults with MS and 67 age-matched controls without cardiovascular disease underwent standardized transthoracic echocardiography. Aortic strain, distensibility and stiffness index (β) were derived from M-mode ascending aortic diameters and simultaneous brachial blood pressure, and LV global longitudinal strain (GLS) was measured by two-dimensional speckle-tracking echocardiography. Multivariable linear regression was utilized to assess associations. Results: LV ejection fraction was similar between groups, while LV GLS was less negative in MS (-17.49 ± 1.81% vs. -19.85 ± 1.80%, p < 0.001). Patients with MS had lower aortic strain (7.54 ± 3.66% vs. 12.91 ± 3.84%) and distensibility (3.81 [2.23-6.06] vs. 5.95 [4.90-9.26] × 10^-3 mmHg^-1) and a higher stiffness index (4.77 [3.10-7.10] vs. 3.44 [2.31-4.05]) (all p < 0.001). After adjustment for age, sex, and body mass index, MS remained independently associated with aortic strain, distensibility, and stiffness index. Within the MS group, aortic strain was independently associated with LV GLS after adjustment for age, sex, body mass index, Expanded Disability Status Scale score and LDL cholesterol (B = -0.276, standardized β = -0.558, p < 0.001). LV GLS was independently associated with log-transformed distensibility (B = -1.021, p = 0.011) and stiffness index (B = 1.095, p = 0.014). Conclusions: Patients with MS show concurrent, inter-related impairment of local ascending aortic elasticity and LV longitudinal deformation despite preserved ejection fraction. Further studies are needed to establish the temporal sequence and prognostic relevance of these findings.