Associations of alterations in pulsatile arterial load with left ventricular longitudinal strain

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Abstract

BACKGROUND Increased arterial stiffness leads to increased pulsatile load on the heart. We investigated associations of components of pulsatile load with a measure of left ventricular (LV) systolic function - global longitudinal strain (GLS), in a community-based cohort ascertained based on family history of hypertension. METHODS Arterial tonometry and echocardiography with speckle tracking were performed in 520 adults with normal LV ejection fraction (EF) (age 67±9 years, 70% hypertensive) to quantify measures of pulsatile load (characteristic aortic impedance (Zc), total arterial compliance (TAC), and augmentation index (AI)) and GLS. The associations of log-Zc, log-TAC, and AI with GLS were assessed using sex-specific z-scores for each measure of arterial load. RESULTS In univariable analyses, higher Zc was associated with worse GLS (less negative) and higher TAC and AI were associated with better GLS (all P <0.001). In a multivariable model including age, sex, heart rate (HR), LVEF, mean arterial load (systemic vascular resistance), and measures of pulsatile load, Zc remained associated with GLS (β = 0.28, P <0.001), while the associations of TAC and AI were no longer significant (P > 0.5). Additional adjustment for cardiovascular risk factors and history of coronary heart disease and stroke did not attenuate the association of Zc with GLS; Zc, sex, HR, LVEF remained associated with GLS after stepwise elimination (all P <0.001). CONCLUSIONS Greater proximal aortic stiffness, as manifested by a higher Zc, is independently associated with worse LV longitudinal function.

Original languageEnglish (US)
Pages (from-to)1325-1331
Number of pages7
JournalAmerican Journal of Hypertension
Volume28
Issue number11
DOIs
StatePublished - Aug 5 2015

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Compliance
Vascular Stiffness
Left Ventricular Function
Manometry
Electric Impedance
Stroke Volume
Coronary Disease
Echocardiography
Stroke
Hypertension

Keywords

  • aortic characteristic impedance
  • arterial load
  • arterial ventricular interaction
  • blood pressure
  • hypertension
  • left ventricular deformation
  • left ventricular function
  • speckle tracking echocardiography

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{243ed6731f3449848ce15c6228f3b158,
title = "Associations of alterations in pulsatile arterial load with left ventricular longitudinal strain",
abstract = "BACKGROUND Increased arterial stiffness leads to increased pulsatile load on the heart. We investigated associations of components of pulsatile load with a measure of left ventricular (LV) systolic function - global longitudinal strain (GLS), in a community-based cohort ascertained based on family history of hypertension. METHODS Arterial tonometry and echocardiography with speckle tracking were performed in 520 adults with normal LV ejection fraction (EF) (age 67±9 years, 70{\%} hypertensive) to quantify measures of pulsatile load (characteristic aortic impedance (Zc), total arterial compliance (TAC), and augmentation index (AI)) and GLS. The associations of log-Zc, log-TAC, and AI with GLS were assessed using sex-specific z-scores for each measure of arterial load. RESULTS In univariable analyses, higher Zc was associated with worse GLS (less negative) and higher TAC and AI were associated with better GLS (all P <0.001). In a multivariable model including age, sex, heart rate (HR), LVEF, mean arterial load (systemic vascular resistance), and measures of pulsatile load, Zc remained associated with GLS (β = 0.28, P <0.001), while the associations of TAC and AI were no longer significant (P > 0.5). Additional adjustment for cardiovascular risk factors and history of coronary heart disease and stroke did not attenuate the association of Zc with GLS; Zc, sex, HR, LVEF remained associated with GLS after stepwise elimination (all P <0.001). CONCLUSIONS Greater proximal aortic stiffness, as manifested by a higher Zc, is independently associated with worse LV longitudinal function.",
keywords = "aortic characteristic impedance, arterial load, arterial ventricular interaction, blood pressure, hypertension, left ventricular deformation, left ventricular function, speckle tracking echocardiography",
author = "Zi Ye and Thais Coutinho and Patricia Pellikka and Vilarraga, {Hector R} and Borlaug, {Barry A} and Kullo, {Iftikhar Jan}",
year = "2015",
month = "8",
day = "5",
doi = "10.1093/ajh/hpv039",
language = "English (US)",
volume = "28",
pages = "1325--1331",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "11",

}

TY - JOUR

T1 - Associations of alterations in pulsatile arterial load with left ventricular longitudinal strain

AU - Ye, Zi

AU - Coutinho, Thais

AU - Pellikka, Patricia

AU - Vilarraga, Hector R

AU - Borlaug, Barry A

AU - Kullo, Iftikhar Jan

PY - 2015/8/5

Y1 - 2015/8/5

N2 - BACKGROUND Increased arterial stiffness leads to increased pulsatile load on the heart. We investigated associations of components of pulsatile load with a measure of left ventricular (LV) systolic function - global longitudinal strain (GLS), in a community-based cohort ascertained based on family history of hypertension. METHODS Arterial tonometry and echocardiography with speckle tracking were performed in 520 adults with normal LV ejection fraction (EF) (age 67±9 years, 70% hypertensive) to quantify measures of pulsatile load (characteristic aortic impedance (Zc), total arterial compliance (TAC), and augmentation index (AI)) and GLS. The associations of log-Zc, log-TAC, and AI with GLS were assessed using sex-specific z-scores for each measure of arterial load. RESULTS In univariable analyses, higher Zc was associated with worse GLS (less negative) and higher TAC and AI were associated with better GLS (all P <0.001). In a multivariable model including age, sex, heart rate (HR), LVEF, mean arterial load (systemic vascular resistance), and measures of pulsatile load, Zc remained associated with GLS (β = 0.28, P <0.001), while the associations of TAC and AI were no longer significant (P > 0.5). Additional adjustment for cardiovascular risk factors and history of coronary heart disease and stroke did not attenuate the association of Zc with GLS; Zc, sex, HR, LVEF remained associated with GLS after stepwise elimination (all P <0.001). CONCLUSIONS Greater proximal aortic stiffness, as manifested by a higher Zc, is independently associated with worse LV longitudinal function.

AB - BACKGROUND Increased arterial stiffness leads to increased pulsatile load on the heart. We investigated associations of components of pulsatile load with a measure of left ventricular (LV) systolic function - global longitudinal strain (GLS), in a community-based cohort ascertained based on family history of hypertension. METHODS Arterial tonometry and echocardiography with speckle tracking were performed in 520 adults with normal LV ejection fraction (EF) (age 67±9 years, 70% hypertensive) to quantify measures of pulsatile load (characteristic aortic impedance (Zc), total arterial compliance (TAC), and augmentation index (AI)) and GLS. The associations of log-Zc, log-TAC, and AI with GLS were assessed using sex-specific z-scores for each measure of arterial load. RESULTS In univariable analyses, higher Zc was associated with worse GLS (less negative) and higher TAC and AI were associated with better GLS (all P <0.001). In a multivariable model including age, sex, heart rate (HR), LVEF, mean arterial load (systemic vascular resistance), and measures of pulsatile load, Zc remained associated with GLS (β = 0.28, P <0.001), while the associations of TAC and AI were no longer significant (P > 0.5). Additional adjustment for cardiovascular risk factors and history of coronary heart disease and stroke did not attenuate the association of Zc with GLS; Zc, sex, HR, LVEF remained associated with GLS after stepwise elimination (all P <0.001). CONCLUSIONS Greater proximal aortic stiffness, as manifested by a higher Zc, is independently associated with worse LV longitudinal function.

KW - aortic characteristic impedance

KW - arterial load

KW - arterial ventricular interaction

KW - blood pressure

KW - hypertension

KW - left ventricular deformation

KW - left ventricular function

KW - speckle tracking echocardiography

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U2 - 10.1093/ajh/hpv039

DO - 10.1093/ajh/hpv039

M3 - Article

C2 - 25840581

AN - SCOPUS:84937501897

VL - 28

SP - 1325

EP - 1331

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 11

ER -