Arterial wave reflection and subclinical left ventricular systolic dysfunction

Cesare Russo, Zhezhen Jin, Yasuyoshi Takei, Takuya Hasegawa, Shun Koshaka, Vittorio Palmieri, Mitchell S.V. Elkind, Shunichi Homma, Ralph L. Sacco, Marco R. Di Tullio

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23 Citations (Scopus)

Abstract

Objectives: Increased arterial wave reflection is a predictor of cardiovascular events and has been hypothesized to be a cofactor in the pathophysiology of heart failure. Whether increased wave reflection is inversely associated with left-ventricular (LV) systolic function in individuals without heart failure is not clear. Methods: Arterial wave reflection and LV systolic function were assessed in 301 participants from the Cardiovascular Abnormalities and Brain Lesions (CABL) study using two-dimensional echocardiography and applanation tonometry of the radial artery to derive central arterial waveform by a validated transfer function. Aortic augmentation index (AIx) and wasted energy index (WEi) were used as indices of wave reflection. LV systolic function was measured by LV ejection fraction (LVEF) and tissue Doppler imaging (TDI). Mitral annulus peak systolic velocity (Sm), peak longitudinal strain and strain rate were measured. Participants with history of coronary artery disease, atrial fibrillation, LVEF less than 50% or wall motion abnormalities were excluded. Results: Mean age of the study population was 68.3 ± 10.2 years (64.1% women, 65% hypertensive). LV systolic function by TDI was lower with increasing wave reflection, whereas LVEF was not. In multivariate analysis, TDI parameters of LV longitudinal systolic function were significantly and inversely correlated to AIx and WEi (P values from 0.05 to 0.002). Conclusions: In a community cohort without heart failure and with normal LVEF, an increased arterial wave reflection was associated with subclinical reduction in LV systolic function assessed by novel TDI techniques. Further studies are needed to investigate the prognostic implications of this relationship.

Original languageEnglish
Pages (from-to)574-582
Number of pages9
JournalJournal of hypertension
Volume29
Issue number3
DOIs
Publication statusPublished - 2011 Mar 1

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Keywords

  • arterial stiffness
  • echocardiography
  • strain
  • strain rate
  • systolic function
  • tissue Doppler
  • wave reflection

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Russo, C., Jin, Z., Takei, Y., Hasegawa, T., Koshaka, S., Palmieri, V., Elkind, M. S. V., Homma, S., Sacco, R. L., & Di Tullio, M. R. (2011). Arterial wave reflection and subclinical left ventricular systolic dysfunction. Journal of hypertension, 29(3), 574-582. https://doi.org/10.1097/HJH.0b013e328342ca56