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The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals

Evelien Hermeling, SEBASTIAN VERMEERSCH UGent, Ernst Rietzschel UGent, MARC DE BUYZERE UGent, Thierry Gillebert UGent, Roel J van de Laar, Isabel Ferreira, Arnold P Hoeks, Lucas Van Bortel UGent and Robert S Reneman, et al. (2012) JOURNAL OF HYPERTENSION. 30(2). p.396-402
abstract
Background: The current standard for arterial stiffness assessment, aortic pulse wave velocity (aPWV), is measured at diastolic pressure. Arterial stiffness, however, is pressure dependent. At the carotid artery level, the degree of this dependency can be quantified as the difference (Delta PWV) between systolic and diastolic (cPWV(d)) carotid pulse wave velocity. Biomechanically, a greater Delta PWV implies greater increases in left ventricular afterload with physical activity. Therefore, we hypothesized, that Delta PWV is more strongly associated with left ventricular mass index (LVMI) than aPWV and cPWV(d). Methods: In 1776 healthy individuals from the Asklepios cohort (age 35-55 years), Delta PWV was obtained from combined carotid artery ultrasound and tonometry recordings. Multiple linear regression analysis was performed to investigate the associations of Delta PWV, cPWV(d) and aPWV with LVMI, adjusting for age, sex, mean blood pressure (MBP), central pulse pressure, and other possible confounders. Results: DPWV was 2.4 +/- 1.2 m/s (mean +/- SD), ranging from 0.8 m/s, indicating almost constant arterial stiffness over the cardiac cycle, to 4.4 m/s, reflecting substantial pressure dependency. Delta PWV was significantly associated with LVMI (beta of 2.46 g/m(1.7) per m/s, P < 0.001), even after full adjustment (beta of 0.56 g/m(1.7) per m/s, P = 0.03). cPWV(d) and aPWV had clear crude associations with LVMI (P < 0.001), but lost significance after adjustment (beta of -0.48 and -0.33 g/m(1.7) per m/s, with P = 0.11 and 0.2, respectively). Conclusion: The change in arterial stiffness over the cardiac cycle, rather than diastolic stiffness, is independently associated with LVMI in healthy middle-aged individuals. Therefore, the pressure dependency of arterial stiffness should be considered in cardiovascular risk assessment.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
cardiac hypertrophy/remodeling, ventricular-arterial coupling, pulse wave velocity, systolic hypertension, arterial structure and compliance, PULSE-WAVE VELOCITY, CAROTID-ARTERY, MECHANICAL-PROPERTIES, HYPERTENSIVE PATIENTS, AORTIC STIFFNESS, BLOOD-PRESSURE, DIAMETER, EXERCISE, HYPERTROPHY, GUIDELINES
journal title
JOURNAL OF HYPERTENSION
J. Hypertens.
volume
30
issue
2
pages
396 - 402
Web of Science type
Article
Web of Science id
000299168200022
JCR category
PERIPHERAL VASCULAR DISEASE
JCR impact factor
3.806 (2012)
JCR rank
13/66 (2012)
JCR quartile
1 (2012)
ISSN
0263-6352
DOI
10.1097/HJH.0b013e32834e4b75
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2037722
handle
http://hdl.handle.net/1854/LU-2037722
date created
2012-02-17 15:30:48
date last changed
2012-03-15 14:47:03
@article{2037722,
  abstract     = {Background: The current standard for arterial stiffness assessment, aortic pulse wave velocity (aPWV), is measured at diastolic pressure. Arterial stiffness, however, is pressure dependent. At the carotid artery level, the degree of this dependency can be quantified as the difference (Delta PWV) between systolic and diastolic (cPWV(d)) carotid pulse wave velocity. Biomechanically, a greater Delta PWV implies greater increases in left ventricular afterload with physical activity. Therefore, we hypothesized, that Delta PWV is more strongly associated with left ventricular mass index (LVMI) than aPWV and cPWV(d). 
Methods: In 1776 healthy individuals from the Asklepios cohort (age 35-55 years), Delta PWV was obtained from combined carotid artery ultrasound and tonometry recordings. Multiple linear regression analysis was performed to investigate the associations of Delta PWV, cPWV(d) and aPWV with LVMI, adjusting for age, sex, mean blood pressure (MBP), central pulse pressure, and other possible confounders. 
Results: DPWV was 2.4 +/- 1.2 m/s (mean +/- SD), ranging from 0.8 m/s, indicating almost constant arterial stiffness over the cardiac cycle, to 4.4 m/s, reflecting substantial pressure dependency. Delta PWV was significantly associated with LVMI (beta of 2.46 g/m(1.7) per m/s, P {\textlangle} 0.001), even after full adjustment (beta of 0.56 g/m(1.7) per m/s, P = 0.03). cPWV(d) and aPWV had clear crude associations with LVMI (P {\textlangle} 0.001), but lost significance after adjustment (beta of -0.48 and -0.33 g/m(1.7) per m/s, with P = 0.11 and 0.2, respectively). 
Conclusion: The change in arterial stiffness over the cardiac cycle, rather than diastolic stiffness, is independently associated with LVMI in healthy middle-aged individuals. Therefore, the pressure dependency of arterial stiffness should be considered in cardiovascular risk assessment.},
  author       = {Hermeling, Evelien and VERMEERSCH, SEBASTIAN and Rietzschel, Ernst and DE BUYZERE, MARC and Gillebert, Thierry and van de Laar, Roel J and Ferreira, Isabel and Hoeks, Arnold P and Van Bortel, Lucas and Reneman, Robert S and Segers, Patrick and Reesink, Koen D},
  issn         = {0263-6352},
  journal      = {JOURNAL OF HYPERTENSION},
  keyword      = {cardiac hypertrophy/remodeling,ventricular-arterial coupling,pulse wave velocity,systolic hypertension,arterial structure and compliance,PULSE-WAVE VELOCITY,CAROTID-ARTERY,MECHANICAL-PROPERTIES,HYPERTENSIVE PATIENTS,AORTIC STIFFNESS,BLOOD-PRESSURE,DIAMETER,EXERCISE,HYPERTROPHY,GUIDELINES},
  language     = {eng},
  number       = {2},
  pages        = {396--402},
  title        = {The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals},
  url          = {http://dx.doi.org/10.1097/HJH.0b013e32834e4b75},
  volume       = {30},
  year         = {2012},
}

Chicago
Hermeling, Evelien, SEBASTIAN VERMEERSCH, Ernst Rietzschel, Marc De Buyzere, Thierry Gillebert, Roel J van de Laar, Isabel Ferreira, et al. 2012. “The Change in Arterial Stiffness over the Cardiac Cycle Rather Than Diastolic Stiffness Is Independently Associated with Left Ventricular Mass Index in Healthy Middle-aged Individuals.” Journal of Hypertension 30 (2): 396–402.
APA
Hermeling, Evelien, VERMEERSCH, S., Rietzschel, E., De Buyzere, M., Gillebert, T., van de Laar, R. J., Ferreira, I., et al. (2012). The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals. JOURNAL OF HYPERTENSION, 30(2), 396–402.
Vancouver
1.
Hermeling E, VERMEERSCH S, Rietzschel E, De Buyzere M, Gillebert T, van de Laar RJ, et al. The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals. JOURNAL OF HYPERTENSION. 2012;30(2):396–402.
MLA
Hermeling, Evelien, SEBASTIAN VERMEERSCH, Ernst Rietzschel, et al. “The Change in Arterial Stiffness over the Cardiac Cycle Rather Than Diastolic Stiffness Is Independently Associated with Left Ventricular Mass Index in Healthy Middle-aged Individuals.” JOURNAL OF HYPERTENSION 30.2 (2012): 396–402. Print.